Practical Projects for Photographers最新文献

Observation 观察

Practical Projects for Photographers Pub Date : 2020-08-13 DOI: 10.4324/9781003103844-2

T. Daly

{"title":"Observation","authors":"T. Daly","doi":"10.4324/9781003103844-2","DOIUrl":"https://doi.org/10.4324/9781003103844-2","url":null,"abstract":"MELAS Syndrome and MIDD Unmasked by Metformin Use: A Case Report Background: Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a syndrome caused by genetic defects in mitochondrial DNA. The most common gene variant associated with this syndrome is the m.3243A>G point mutation in the MT-TL1 gene. This variant is also responsible for a rare type of diabetes known as maternally inherited diabetes and deafness (MIDD). Metformin is widely prescribed as the initial drug treatment for type 2 diabetes mellitus, and one of its cellular targets is mitochondrial respiration in hepatocytes (1). Metformin has not been studied in patients with mitochondrial dysfunction, so its use is discouraged in these patients (2). Objective: To describe how use of metformin can reveal the presence of MELAS syndrome and MIDD. Case Report: A 27-year-old White man was evaluated in our emergency department for new-onset seizure disorder. He had been in his usual state of good health until the evening before admission, when he had headache and malaise followed by a generalized tonic-clonic seizure. His medical history included bilateral sensorineural hearing loss diagnosed at age 15 years and recently diagnosed diabetes mellitus. On physical examination, he had no focal neurologic deficits. His initial laboratory results included a plasma glucose level of 10.5 mmol/L (189 mg/dL) and an elevated lactic acid level (2.5 mmol/L; reference range, 0.7 to 2.0 mmol/L). Brain magnetic resonance imaging showed multifocal areas of T2 signal abnormalities in the gray matter of the temporal lobes bilaterally with limbic sparing (Figure). He was admitted and given intravenous acyclovir for empirical treatment of herpes simplex encephalitis. This treatment was stopped after 2 lumbar punctures found cerebrospinal fluid with aseptic characteristics that was negative for herpes simplex virus types 1 and 2. Cultures of blood and spinal fluid were negative for bacterial, viral, mycobacterial, and fungal organisms. A serum autoimmune encephalitis panel and computed tomography of the thorax, abdomen, and pelvis did not identify autoimmune or paraneoplastic explanations for his seizure, and epileptiform discharges were not found on multiple electroencephalograms. Type 1 diabetes was unlikely because he had normal C-peptide levels and his serum was negative for antibodies to glutamic acid decarboxylase, islet cells, and the IA-2 tyrosine phosphatases. Additional information suggested other diagnoses. Repeated brain magnetic resonance imaging on day 8 of his hospitalization found persistent bilateral temporal lobe lesions, and his lactic acidosis persisted (3.7 mmol/L). We focused on his 4-month history of metformin use and decided to sequence his mitochondrial DNA, which confirmed the m.3243A>G mutation that is associated with MELAS syndrome and MIDD, with a heteroplasmy level of 48%. We discontinued the patient's metformin treatment and discharged him with a glipizide","PeriodicalId":298429,"journal":{"name":"Practical Projects for Photographers","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126462335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In the present 在现在

Practical Projects for Photographers Pub Date : 2020-08-13 DOI: 10.4324/9781003103844-6

T. Daly

引用次数: 0

About the past 关于过去

Practical Projects for Photographers Pub Date : 2020-08-13 DOI: 10.4324/9781003103844-5

T. Daly

引用次数: 0

Telling stories 讲故事

Practical Projects for Photographers Pub Date : 2020-08-13 DOI: 10.4324/9781003103844-4

T. Daly

引用次数: 0

Emphasis 强调

Practical Projects for Photographers Pub Date : 2020-08-13 DOI: 10.4324/9781003103844-3

T. Daly

引用次数: 14

Travel 旅行

Practical Projects for Photographers Pub Date : 1937-11-01 DOI: 10.1787/ea83a639-en

T. Daly

{"title":"Travel","authors":"T. Daly","doi":"10.1787/ea83a639-en","DOIUrl":"https://doi.org/10.1787/ea83a639-en","url":null,"abstract":"These results can be integrated into the calculation of economic speed. Thus, from the standpoint of a car-owner earning three times the minimum wage (24 euros per hour), driving a car by yourself for a trip within Paris, at a private cost of 25 cents per kilometer, corresponds to an economic speed of 96 km/h. With one hour of work, this person can buy a 96 km trip. This result explains why the use of cars in urban areas persists. However, if it is a diesel car, the public cost of which isn’t covered by taxes, this amounts to 6.81 euros per kilometer, which equates to a social cost of 7.06 euros. By analysing this in relation to the hourly wage, we get a socio-economic speed of 3.4 km/h 6 . It is therefore understandable why most big cities seek to reduce or even eliminate diesel cars. There is therefore a huge gap, in urban areas, between the individual perception of economic speed and the collective measure of socio-economic speed. In this case we come back to Ivan Illich's harsh observation on cars. Given the social costs they require, the socio-economic speed of cars in an urban setting, from the community’s point of view, is much lower than the economic speed is for the individual user. It’s worth noting that even for electric cars, the socio-economic speed in urban areas barely exceeds 10 km/h. In general, public policies are therefore focused on reducing the supremacy of cars in cities, regardless how they are powered. Socio-economic speed thus becomes a valuable indicator for collective mobility choices (Crozet 2013). There are indeed other cases where socio-economic speed is much lower than economic speed, such as some high-speed railway projects (LGV, for Lignes ferroviaires à grande vitesse) that would require significant public subsidies for low volumes of traffic. The ticket cost (about 10 cents/km) could end up being 5 times lower than the social cost (50 cents/km). For a person earning twice the minimum wage, while the economic reduce safety costs, but also, in dense areas, of noise and atmospheric pollution. The same applies to all regulations such as vehicle safety inspections or CO² emission thresholds. In the same vein, prioritizing collective transport or active modes in urban areas is another way of pursuing this goal of reducing the environmental impacts of mobilities. But public policies don’t call into question the general trend to increase the economic speed of different modes of transport, and therefore more generally to increase mobility. Given the commitments we made in the Paris Agreement and considering other impacts such as the degradation of biodiversity or the shrinking of available farmland, we will unquestionably have to take far more binding measures that challenge the very idea of a steadily growing economic speed. This could mean heavily taxing kerosene, or implementing congestion charges in major cities or steadily increasing the price of fossil fuels... Yet this simple list of suggestions is enough to show ","PeriodicalId":298429,"journal":{"name":"Practical Projects for Photographers","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1937-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132292638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In the present 在现在

Practical Projects for Photographers Pub Date : 1900-01-01 DOI: 10.5040/9781350056114.ch-005

引用次数: 0