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There is also reason to believe that patients with hypothyroidism have an increased rate 62 of spontaneous abortion spa hair treatment cheap zyloprim 300 mg with mastercard. The mechanism may be impaired ability of important organs such as the endometrium and the corpus luteum daughter medicine buy cheap zyloprim on line. Women being treated for 63 medicine man dispensary cheapest zyloprim, 64 hypothyroidism require an increase (20–50%) in thyroxine during pregnancy symptoms nervous breakdown cheap zyloprim 100mg without prescription. Postpartum Thyroiditis Autoimmune thyroid disease is suppressed to some degree by the immunologic changes of pregnancy. Thus, there is a relatively high incidence of postpartum thyroiditis (5–10%), usually 3–6 months after delivery, manifested by either hyperthyroidism or hypothyroidism, although commonly transient hyperthyroidism is 65 66 followed by hypothyroidism. This condition is due to a destructive thyroiditis associated with thyroid microsomal autoantibodies. Women at high risk for postpartum thyroiditis are those with a personal or family history of autoimmune disease, and those with a previous postpartum episode. Most importantly, the symptoms in these women are often attributed to anxiety or depression, and the obstetrician must have a high index of suspicion for hypothyroidism. The symptoms usually last 1–3 months, and almost all women return to normal thyroid function. Postpartum thyroiditis tends to recur with subsequent 68 pregnancies, and eventually hypothyroidism remains. The symptoms of hyperthyroidism in this condition are not responsive to antithyroid medication, and patients are usually not treated or given beta-adrenergic blocking agents . Because spontaneous remission is common, patients who are treated with hypothyroidism should be reassessed one year after gradual withdrawal of thyroxine. Patients who return to normal should undergo periodic laboratory surveillance of their thyroid status. Monzani F, Caraccio N, Siciliano G, Manca L, Murri L, Ferrannini E, Clinical and biochemical features of muscle dysfunction in subclinical hypothyroidism, J Clin Endocrinol Metab 82:3315, 1997. Wartofsky L, Osteoporosis and therapy with thyroid hormone, Endocrinologist 1:57, 1991. Diamond T, Nery L, Hales I, A therapeutic dilemma: suppressive doses of thyroxine significantly reduce bone mineral measurements in both premenopausal and postmenopausal women with thyroid carcinoma, J Clin Endocrinol Metab 72:1184, 1991. Barsony J, Lakatos P, Foldes J, Feher T, Effect of vitamin D 3 loading and thyroid hormone replacement therapy on the decreased serum 25-hydroxyvitamin D level in patients with hypothyroidism, Acta Endocrinol 113:329, 1986. Pacini F, Fontanelli M, Fugazzola L, Elisei R, Romei C, Di Coscio G, Miccoli P, Pinchera A, Routine measurement of serum calcitonin in nodular thyroid diseases allows the preoperative diagnosis of unsuspected sporadic medullary thyroid carcinoma, J Clin Endocrinol Metab 78:826, 1994. Glinoer D, the regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology, Endocr Rev 18:404, 1997. Glinoer D, DeNayer P, Bourdoux P, Lemone M, Robyn C, Van Steirteghem A, Kinthaert J, Lejeune B, Regulation of maternal thyroid during pregnancy, J Clin Endocrinol Metab 71:276, 1990. Yamazaki K, Sato K, Shizume K, Kanaji Y, Ito Y, Obara T, Nakagawa T, Koizumi T, Nishimura R, Potent thyrotropic activity of human chorionic gonadotropin variants in terms of 125I incorporation and de novo synthesized thyroid hormone release in human thyroid follicles, J Clin Endocrinol Metab 80:473, 1995. Tsuruta E, Tada H, Tamaki H, Kashiwai T, Asahio K, Takeoka K, Mitsuda N, Amino N, Pathogenic role of asialo human chorionic gonadotropin in gestational thyrotoxicosis, J Clin Endocrinol Metab 80:350, 1995. Maruo T, Katayama K, Matuso H, Anwar M, Mochizuki M, the role of maternal thyroid hormones in maintaining early pregnancy in threatened abortion, Acta Endocrinol 127:118, 1992. Kung woman, a member of an African tribe of hunter-gatherers, experienced 15 years of lactational amenorrhea, 4 years of pregnancy, and only 48 1 menstrual cycles. Contemporary women undergo earlier menarche and start having sexual intercourse earlier in their lives than in the past. Even though breastfeeding has increased in recent years, its duration is relatively brief, and its contribution to contraception in the developed world is trivial. Therefore, it is more difficult today to limit the size of a family unless some method of contraception is utilized. The teenage pregnancy rates in 5 northern European countries and Canada range from 13 to 53% of the U. This is largely because American men and women after age 25 utilize surgical sterilization at a great rate. American women age 20–34 have the highest proportion of pregnancies aborted compared with other countries, indicating an unappreciated, but real, problem of unintended pregnancy existing beyond the teenage years. Delaying marriage prolongs the period in which women are exposed to the risk of unintended pregnancy. This, however, cannot be documented as a major reason for the large differential between young adults in Europe and the U. The available evidence also indicates that a difference in sexual activity is not an important explanation. The major difference between American women and European women is that American women under age 25 are less likely to use any form of 2 contraception. Significantly the use of oral contraceptives (the main choice of younger women) is lower in the U. The cultures in areas such as the United Kingdom and the Scandinavian countries are certainly very similar with similar rates of sexual experience. In the rest of the world, contraceptive services can be obtained from more accessible resources and relatively inexpensively. Major problems are the enormous diversity of people and the unequal distribution of income in the U. These factors influence the ability of our society to effectively provide education regarding sex and contraception and to effectively make contraception services available. The era of modern contraception dates from 1960 when oral contraception was first approved by the U. The clinician must be aware of the definitions and measurements used in assessing contraceptive efficacy and must draw on the talents of appropriate experts in this area to summarize the accurate and comparative failure rates for the various methods of contraception. Definition and Measurement Contraceptive efficacy is generally assessed by measuring the number of unplanned pregnancies that occur during a specified period of exposure and use of a contraceptive method. The two methods that have been used to measure contraceptive efficacy are the Pearl index and life-table analysis. The Pearl Index the Pearl index is defined as the number of failures per 100 woman-years of exposure. The denominator is the total months or cycles of exposure from the onset of a method until completion of the study, an unintended pregnancy, or discontinuation of the method. The quotient is multiplied by 1200 if the denominator consists of months or by 1300 if the denominator consists of cycles. The Pearl index is usually based on a lengthy exposure (usually one year) and, therefore, fails to accurately compare methods at various durations of exposure. Life-Table Analysis Life-table analysis calculates a failure rate for each month of use. A cumulative failure rate can then compare methods for any specific length of exposure. Women who leave a study for any reason other than unintended pregnancy are removed from the analysis, contributing their exposure until the time of the exit. Thus, “method effectiveness” and “use effectiveness” have been used to designate efficacy with correct and incorrect use of a method. It is less confusing to simply compare the very best performance (the lowest expected failure rate) with the usual experience (typical failure rates) as noted in the table of failure rates during the first year of use. The lowest expected failure rates are determined in clinical trials, where the combination of highly motivated subjects and frequent support from the study personnel yields the best results. It should be noted that slightly more than half of the unintended 4 pregnancies in the U. Contraceptive Use in the United States the National Survey of Family Growth is conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. The percent of married couples using sterilization as a method of contraception more than doubled from 1972 to 1988, and has remained stable since then. The use of oral contraception reached a high in 1992, and then decreased in 1995, especially among Hispanic and black Americans. Among never married women, oral contraception has been the leading method of birth control, but from 1988 to 1995, oral contraceptive use decreased in women younger than 25 and rose among women aged 30–44.
An exception to this overall pattern of positive influence is the control of prolactin secretion medicine quetiapine generic zyloprim 100 mg line. Stalk secretion and transplantation cause release of prolactin from the anterior pituitary symptoms 1dpo discount zyloprim uk, implying a negative hypothalamic control treatment wetlands discount 300mg zyloprim visa. Furthermore treatment quinsy purchase online zyloprim, cultures of anterior pituitary tissue release prolactin in the absence of hypothalamic tissue or extracts. The neurohormone that controls prolactin is called prolactin-inhibiting hormone and is dopamine. In addition to their effects on the pituitary, behavioral effects within the brain have been demonstrated for several of the releasing hormones. Brain peptides require gene transcription, translation, and posttranslational processing, all within the neuronal cell body, the final product being transported down the axon to the terminal for secretion. Small neuroendocrine peptides share common large precursor polypeptides, called polyproteins or polyfunctional peptides. These proteins can serve as precursors for more than one biologically active peptide. It is present in both neural and nonneural tissues, and receptors are present in many extrapituitary tissues (such as the ovarian follicle and the placenta). Prompted by its existence in other species, a search for its presence in humans was ultimately successful. Although it is highly regulated by input from other sites, its function is essential for sustaining life. Pituitary development and activity are under the control of the hypothalamus (with input from other central nervous sytem sites), and pituitary response is finely tuned by hormonal messages from tissues that are the targets of the pituitary trophic hormones. In addition, the pituitary has its own autocrine/paracrine system for enhancement and suppression of growth and function. But the pituitary gland is the focus for all of this activity, and this central, coordinating role is critical for normal life. Prolactin Secretion Prolactin gene expression occurs in the lactotrophs of the anterior pituitary gland, in decidualized endometrium, and the myometrium. In addition, prolactin gene transcription is regulated by the interaction of estrogen and glucocorticoid receptors with 5¢ flanking sequences. Mutations in the sequences of these flanking regions or in the gene for the Pit-1 protein can result in the failure to secrete prolactin. Molecular studies indicate that Pit-1 participates in mediating both stimulatory and inhibitory hormone signals for prolactin gene transcription. However, alterations in Pit-1 gene expression are not involved in pituitary 9 tumor formation. The main function of prolactin in mammals is lactogenesis, while in fish prolactin is important for osmoregulation. The prolactin gene from the Chinook salmon 10 contains coding sequences that are similar to those in mammals, and it is regulated similarly in the pituitary. Pit-1, the pituitary specific transcription factor, therefore, appears to be highly conserved among species. Prolactin gene transcription is stimulated by estrogen and mediated by estrogen receptor binding to estrogen responsive elements. This activation by estrogen requires interaction with Pit-1, in a manner not yet determined. Proximal promoter sequences are also activated by peptide hormones binding to cell surface receptors; e. Pituitary secretion of prolactin is chiefly under the inhibitory control of hypothalamic dopamine released into the portal circulation. The action of dopamine in the pituitary is mediated by receptors that are coupled to the inhibition of adenylate cyclase activity. There are 5 forms of the dopamine receptor, divided into 2 functional 11 groups, D1 and D2. The structure and function of the dopamine receptors are of the G protein system as described in Chapter 2. Other mechanisms are also activated, including suppression of intracellular calcium levels. In addition to direct inhibition of prolactin gene expression, dopamine binding to the D 2 receptor also inhibits lactotroph development and growth. These multiple effects of dopamine explain the ability of dopamine agonists to suppress prolactin secretion and the growth of prolactin-secreting pituitary adenomas. No activating or inactivating mutations of the dopamine receptors have been reported. These factors interact with each other, affecting the overall lactotroph responsiveness. Within the hypothalamus are peptidergic neural cells that secrete the releasing and inhibiting hormones. They respond to signals in the bloodstream, as well as to neurotransmitters within the brain, in a process known as neurosecretion. In neurosecretion, a neurohormone or neurotransmitter is synthesized on the ribosomes in the cytoplasm of the neuron, packaged into a granule in the Golgi apparatus, and then transported by active axonal flow to the neuronal terminal for secretion into a blood vessel or across a synapse. Three modes of transmission 15 have been documented: X-linked, autosomal dominant, and autosomal recessive. The 5–7-fold increased frequency in males indicates that X-linked transmission is the most common. The mutations responsible for this syndrome result in the failure to produce a protein (homologous to members of the fibronectin family) 16, 17 responsible for cell adhesion and protease inhibition, functions necessary for neuronal migration. Pheromones are airborne chemicals released by one individual that can affect other members of the same species. This may be one mechanism by which women who are together much of the time often exhibit a synchrony in menstrual cycle timing. Only lesions of the arcuate nucleus in the monkey lead to gonadal atrophy and amenorrhea. This function, in turn, depends upon the complex and coordinated interrelationships among this releasing hormone, other neurohormones, the pituitary gonadotropins, and the gonadal steroids. The interplay among these substances is governed by feedback effects, both positive stimulatory and negative inhibitory. The long feedback loop refers to the feedback effects of circulating levels of target gland hormones, and this occurs both in the hypothalamus and the pituitary. The short feedback loop indicates a negative feedback of pituitary hormones on their own secretion, presumably via inhibitory effects on releasing hormones in the hypothalamus. Ultrashort feedback refers to inhibition by the releasing hormone on its own synthesis. Dopamine is the immediate precursor of norepinephrine, but dopamine itself functions as a key neurotransmitter in the hypothalamus and the pituitary. Increasing the frequency to 2 and 5 pulses per hour extinguishes gonadotropin secretion. After puberty, enhanced pulsatile secretion is maintained throughout the 24-hour period, but it varies in both amplitude and frequency. Late luteal phase 200 minutes Pulsatile secretion is more frequent but lower in amplitude during the follicular phase compared to the luteal phase. There is considerable variability between and within individuals and a wide normal range exists. Cell bodies for dopamine synthesis can be found in the arcuate and periventricular nuclei. The dopamine tuberoinfundibular tract arises within the medial basal hypothalamus and projects to the median eminence. Dopamine is directly secreted into the portal blood, thus behaving like a neurohormone. But it is this pathway that directly participates in the regulation of prolactin secretion. Most of the cell bodies that synthesize norepinephrine are located in the mesencephalon and lower brainstem.
Frequency/Duration – One to 3 sessions over 6 weeks medications prescribed for anxiety cheap zyloprim online, primarily to facilitate an active exercise program and compliance 714x treatment for cancer cheap zyloprim 300 mg without prescription. Content is suggested to be focused on active exercises rather than passive interventions or disease pathophysiology as this may be helpful symptoms bipolar order zyloprim visa, particularly in addition to an active exercise program when compliance is challenging or periodic encouragement and facilitation to overcome incapacity in patients with severe osteoarthrosis medications for bipolar generic 300mg zyloprim visa. Studies compare exercise to non-exercise controls,(476, 494-496, 508, 545-547, 552-566) exercise to exercise,(567-574) and exercise to other treatments(575-579) (see Exercise evidence table). Some exercise programs were unstructured and some studies did not clearly describe the interventions. These limitations preclude drawing strong evidence-based conclusions regarding any single intervention. Yet, there are quality studies comparing exercise to non-exercise controls (580) that allow evidence-based conclusions to be made on the relative value of aerobic, stretching, and strengthening exercises. There also is experimental evidence that the glycosaminoglycan content in the post-meniscectomized knee is superior if exercised. A high-quality trial of knee osteoarthrosis suggests that while both aerobic and resistance training are helpful, aerobic exercises are modestly superior to resistance training and far superior to education. All quality studies which included a major component of documented compliance with increased aerobic exercise found benefits of aerobic exercise. There is not clear superiority of aerobic or strengthening exercises or vice versa. The available quality evidence suggests aerobic and strengthening exercises are superior to flexibility or range-of-motion exercises. Pool-based programs have been evaluated and evidence of superiority of water-based programs is lacking (see Aquatic Therapy). Evidence is mixed regarding whether supervised exercise programs are necessary or whether home-based programs are sufficient. Exercise programs are not invasive, have low adverse effects, and are low to moderate cost depending on numbers of supervised appointments. Programs emphasizing aerobic and strengthening exercises are recommended, as is stretching for those with considerable reductions in range of motion that do not appear fixed. Educational programs are largely ineffective compared to exercise or other active treatments. However, a few educational visits to emphasize need for exercise and to tailor exercise and other activities are recommended in concert with an exercise prescription, as educational interventions have low adverse effects and are not costly. There is moderate quality evidence a combination of exercise and weight loss is effective for osteoarthrosis, providing additional rationale for educational interventions targeted at weight loss. Author/Yea Scor Sample Comparison Results Conclusion Comments r e (0- Size Group Study Type 11) Exercise for Post-surgery Patients Ebert 4. Patient femoral at 8 weeks post- traditional follow-up to at least condylar op) patients had 464. Activity at 3 required to observe knee used single months: accelerated longer-term graft crutch in both 101115±462 vs. These data suggest 69% and results 40-minute Knee extension that exercise should were better with resistance strength 89. Prior spent exercising behavior exercise (see behavior best ([almost equal to] important above). Furthermore, once participants completed the first 3 months of their training, prior behavior was the strongest predictor of exercise compliance. Pain in past week the effects is value of specific no exercise for reduced after medium to small, treatments. No significant assessments effectiveness improved, but no differences between difference in hip and knee. No performance, improvements were including going up apparent in the and down stairs. Global inflammatory drugs, differences and information assessment trends at and high patient between active by one phone 3 months improved for satisfaction. Spa week follow-up therapy of 3 weeks with multiple co- Copyright 2016 Reed Group, Ltd. No spring water and suggest reduction in symptomatic effect long-term follow- medical benefits over time. Pain score of life in the exercise trended in favor of group compared to exercise group. Data appointments for Harris Hip Score: for older adults with suggest exercise 8 weeks vs. The training program may be accompanied by adverse effects such as knee effusions. No past 2 strengthening, significant differences months and stretching) between groups in vs. Step test and stair climb test not statistically significant for main effect of alignment and strengthening. Importantly, endurance the improvement exercise for was still evident 12 fatigue) 2 times a months following week vs. Mean peak torque at knee flexion and extension during concentric and eccentric contractions at 60° and 180° statistically significant for all treatment groups within comparison and between-group comparison for all measures. Adding a small present and not bicycle, Six-minute walk: clinic number of well controlled. Both pain and activity differences in groups 30 reps limitations are baseline per leg a day, 5 problem. Exercises 3 Isokinetic exercise times a week for caused the greatest 8 weeks (24 increase of walking sessions). All speed and decrease treated with 20 of disability after minutes of hot treatment and at packs, passive follow-up. Regular check- up done every 4 weeks and comparison of both groups done at 24 weeks. Data for rehab exercise across Lesquesne effect on the quality suggest exercise (stretching, index (p = 0. Median scores closed kinetic for Lequesne index chain weight (control/exercise) at 3 bearing)] plus months: 13/5. This obtaining information programme of on need for regular standardised exercise: 117 (92. Peak strength training] data at 6 weeks exercise plus physical activity tended to have although article health education differed between larger increases in mentions 6 (pain groups with education [physical activity] at months. Well- Although the present being did not change study was unable to between groups. Compliance quadriceps scores at 24 months significantly reduce may have strengthening for controls 7. Exercise only or control groups visited Q4months for 24 months; 24 months follow- up. Additional functional despite pain, n = tasks improved (p cognitive treatment measures. This exercise groups sessions twice a study, therefore, (either land- or week for 4 provides some water-based). The disease activity minutes twice a in swollen joints during rheumatoid arthritis reduced with week for 8 control period (42 to activity decreased exercise as weeks vs. Furthermore, overall symptoms of fatigue, pain, and depression were positively influenced in this selective Copyright 2016 Reed Group, Ltd. Muscle ability of some to individual strength in high complete exercise intensity group ergometer test. Patients somewhat longer controls to reporting greater at baseline, maintain current physical activity had providing some activity level for greater baseline potential bias 12 weeks. Numbers of does not support aggregate 15 minute swollen joints not that training lessons analyses overall training different. Lack of relaxation; (C) variables; 66% of all data from end of weekly in- patients experienced a training impair hospital training general improvement of ability to as per B; (D) disease activity or conclude short to Same as C activity of daily living. All changes (2 at 1 week, 1 for dynamic group on at 3 weeks, 1 at 25 subtests positive 6 weeks) vs.
In conclusion medicine omeprazole 20mg order zyloprim online now, this article treatment borderline personality disorder purchase cheap zyloprim line, constructed with 6 different chapters medicine vocabulary buy zyloprim 100 mg with amex, provides a current overview of different aspects of aortic surgery in France symptoms 5 days before missed period discount zyloprim express. Beside the six large centres that were asked to present a speci c area of their activity here, numerous other French and foreign vascular surgery departments will present a large selection of communications about the modern treatment of aortic disease, during our next meeting (21-24 June, 2013). Roberto Chiesa (Milan) and all the Administration Council of the French Society of Vascular Surgery will be honoured to welcome you, during this scienti c and friendly event in Nice, the most Italian French city... Endovascular treatment of infrarenal abdominal aneurysms by the Stentor system: preliminary results of 79 cases. Mid-term results of a second generation bifurcated endovascular graft for abdominal aortic aneurysm repair: the French Vanguard trial. Becquemin J, Bourriez A, D’Audiffret A, Zubilewicz T, Kobeiter H, Allaire E et al. Mid-term results of endovascular versus open repair for abdominal aortic aneurysm in patients anatomically suitable for endovascular repair. Midterm survival after endovascular versus open repair of infrarenal aortic aneurysms. J Endovasc Ther 2002 Mar -Apr;9 (2):203 -7 2002 Mar ;9 ():203 -207 2002 April 1;9:203-7. Peroperative factors in uencing the outcome of elective abdominal aorta aneurysm repair. Eur J Vasc Endovasc Surg 2000 Jul ;20 (1):84 -9 2000 Jul ;20 ():84 -89 2000 July 7;20:84-9. Abdominal aortic aneurysm sac behavior following Cook Zenith graft implantation: a ve-year follow-up assessment of 212 cases. Colon ischemia following abdominal aortic aneurysm repair in the era of endovascular abdominal aortic repair. A randomized controlled trial of endovascular aneurysm repair versus open surgery for abdominal aortic aneurysms in low- to moderate-risk patients. Outcomes of secondary interventions after abdominal aortic aneurysm endovascular repair. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms. An analysis of the French multicentre experience of fenestrated aortic endografts: medium-term outcomes. Technical aspects, current indications, and results of chimney grafts for juxtarenal aortic aneurysms. Endovascular repair of ruptured abdominal aortic aneurys: logistic and short-term results. Impact of endovascular repair on early outcomes of ruptured abdominal aortic aneurysms. In uence of endograft oversizing on device migration, endoleak, aneurysm shrinkage, and aortic neck dilation: results from the Zenith Multicenter Trial. Research Unit (e-Services for Life and Health) Scienti c Institute San Raffaele 2012 has been a great year for the bicycle in Italy: it has been con rmed as the new means of transportation for urban mobility and leisure. Bicycle’s great potential makes it an ideal instrument for the development of a healthy, ecological and sustainable lifestyle where physical activity and mobility can become essential triggers both for individuals’ and society’s greater care and attention towards health and the environment. It’s main objective is to promote the correct and safe use of this revolutionary (as well as entertaining) means of transport and to promote users’ knowledge and awareness of every aspect of the bicycle’s ecosystem, through an interdisciplinary and hands-on approach. The Bicycle University strives to address the world of the bicycle in a multilayered manner so as to involve the individual in a process of growth - be he/she a cyclist (either beginner or expert, commuter or tourist), the owner of a business (from the bicycle store owner, to the manager of a B&B specialized in housing cyclists), or a public administrator. The aim of the Bicycle University’s hands-on approach is to provide all the tools necessary to widen and deepen cyclists’ personal motivation, and general knowledge on bicycles and their conscientious use. At the same time, the Bicycle University also strives to provide professionals with useful suggestions 264 regarding urban planning, the integration and the supply of technological services, the development of an educational and awareness support system, and technology innovation by providing a meeting-place for end-users and business actors. The main sections that compose the experimental program of the Bicycle University are as follows: History of the bicycle this section will analyze the bicycle’s evolution over history, focusing speci cally on its role and its use over time. Some of the topics that will be covered include: • Leonardo Da Vinci and the bicycle. Man this section will address the bicycle as instrument for man’s wellbeing, from a physical, emotional and social point of view. Some items of this unit will include: • the bicycle: an instrument for health promotion, recreation and sports, discovery and knowledge. The medium this unit will focus more in depth on the physical and mechanical aspects of the bicycle, as well as the technological evolutions that have changed the medium as well as the accessories. This part of the course will also tackle topics such as public administration’s planning activities, services (commercial and non) that can be offered to cyclists, especially technological infrastructures and integrated ones. The educational program offered by the Bicycle University is extremely wide but can be directed in such a way so that it can be replicated over time and scaled according to the resources available and the target audience. The rst Bicycle University will be launched during the 5th “Aortic Surgery and Anesthesia - How to do it” International Congress. Such an event was chosen in order to highlight the importance of adopting a more healthy lifestyle through correct physical activity. Since this rst edition of the University will address only a few of the themes previously mentioned, and will focus on forming the cyclist. The topics will be presented through a series of seminars and will focus on the road code, the standards for safety and quality in cycling activity, the potentials of new technologies, the biomechanics of both man and the bicycle, the relationship between the cyclists and the urban environment, cyclist safety and comfort and the use of the bicycle as instrument for man’s wellbeing, from a physical, emotional and social point of view. Concurrently, a great deal of time will be dedicated to prepare cyclists from a practical point of view through a series of hands-on labs where they will be taught the foundations for the correct maintenance for their two-wheeled vehicle. A collaborative approach with the end user will be useful in order to generate improvements of the training process for the following editions. Participants will be able to in uence the structure and running of the course with 266 their feedbacks, as well as have the opportunity of becoming speakers of a personal experience involving the bicycle. The University could also evolved and develop into a on-line version also suitable for children (“Bicycle University – for kids! A playful and engaging approach can help children appreciate and understand important and useful messages related to ”health literacy” and to motivate them into adopting correctly executed physical activity. Apart from the economic contribution, which is clearly indispensable for the organization of such an event, we thank these companies for their profound and dedicated commitment to developing and continuously improving products without which our daily work would in fact be inconceivable. We also thank the non-medical companies that have honoured us with their partnership; they offer great examples of Italian excellence in the world. With reference to Anesthesia and Vascular elds, ab medica operates on the market with innovative products like the new generation central venous catheters and new catheters for mini-invasive treatment of the vascular disease. The mission of ab medica is to make minimally invasive and non-invasive technologies available to the greatest number of people, thus enabling more precise interventions, faster and less painful post-operative recovery. The aim of ab medica has always been the research of advanced medical technologies able to reduce risks, operative trauma and recovery times, thus signi cantly improving both the quality of care and the quality of life of patients. For these reasons, and thanks to the expertise of its staff, ab medica is considered the best partner for any company introducing innovative products into the Italian hospital system. Furthermore, the company is now committed to broadening its horizons, working outside Italy with branches in some European countries such as Switzerland, Croatia, France and Germany. Moreover, since 2004, ab medica is a production Centre and Research & Development scienti c park, engaged in the design and realization of a vast range of products and projects ranging from disposable kits for procedures to a broad range of instruments for minimally invasive surgery and committed to ambitious achievements in the elds of stem cells and genomics. Each year, ab medica participates in numerous conferences, both in Italy and abroad, to spread knowledge about new technologies, promoting their use through the organization of workshops, seminars and meetings with clients. Headquartered in Northern California, we are committed to advancing patient care by transforming the treatment of vascular disease through medical device innovations, investments in research and development, and physician training and education. We offer cutting-edge devices for coronary artery disease, peripheral vascular disease, carotid artery disease and structural heart disease. In addition, our comprehensive product portfolio includes bare metal stents, balloon catheters, guide wires and vessel closure devices. Range of activities: manufacturing and marketing, import and export of chemical, pharmaceutical, biological products, medical devices, patents, formulas and trademarks concerning the biochemical, biotechnological, pharmaceutical and cosmetic areas. The Company, established in 1978, had, at the origin, the aim of forming and training staff members in biochemical, biotechnological and pharmaceutical areas. In addition to this activity, during its rst twenty-year period the Company developed intense research activities on new biotechnological products, up to realize in partnership with some of the major Pharmaceutical European Companies a number of patents having biochemical, biotechnological and nanotechnological matrices, which are, as of today, extended and utilized in many European Countries and outside Europe. Their action, for the period in complete contrast to the logic of the pharmaceutical market, which envisaged exclusive use of synthesis molecules, has concerned all areas of the Company, converting them, and brought to focus its activity on the production and marketing in Italy and abroad of chemical and pharmaceutical products, having strictly biological extractive origin (nutraceuticals), as well as of patents, formulas and trademarks concerning biochemical, biotechnological, nanotechnological areas and dermocosmetics.
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