Análise comportamental de recém-nascidos pré-termos incluídos em um programa de estimulação tátil-cinestésica durante a internação hospitalar

OBJETIVO: Avaliar o efeito da estimulação tátil-cinestésica na evolução do padrão comportamental e clínico de recém-nascidos pré-termos (RNPT) durante o período de internação hospitalar. MÉTODOS: Trinta e dois RNPT, com peso ao nascimento inferior a 2.500 gramas, clinicamente estáveis e destituídos de asfixia perinatal importante foram divididos em 16 bebês do grupo controle (GC) e 16 do experimental (GE). Foram coletados dados da evolução clínica a partir dos registros hospitalares e da avaliação comportamental por meio de filmagens semanais de oito minutos, desde a inclusão do RNPT na amostra até a alta hospitalar. RESULTADOS: Tendência a redução do tempo de internação hospitalar, aumento do ganho de peso diário e predominância de comportamentos auto-organizados (respiração regular, estado de alerta, tônus equilibrado, posturas mistas, movimentação coordenada, movimentos de mão na face, sucção, preensão, apoio) para os RNPT do GE. A análise comparativa das idades pós-conceptuais divididas em intervalos (I - 31 a 33 semanas 6/7; II - 34 a 36 semanas 6/7; e III - 37 a 39 semanas 6/7) ressaltou, no aspecto motor, um tônus equilibrado e movimentação voluntária coordenada para os três períodos, maior permanência em posturas mistas (intervalo I) ou em flexão (intervalo II) e a obtenção de respiração mais regular na faixa etária I do GE. CONCLUSÃO: Destaque da estimulação tátil-cinestésica como método de intervenção durante o período de internação hospitalar, contribuindo para a auto-organização e regulação comportamental de RNPT. Artigo registrado no Australian New Zealand Clinical Trials Registry (ANZCTR) sob o número ACTRN12610000133033.

Reduced Red Cell 2,3-Diphosphoglycerate Concentrations in Critical Illness without Decreased In Vivo P50

We investigated whether red cell 2,3-diphosphoglycerate (2,3-DPG) concentrations are reduced in critical illness, whether acidaemia, hypophosphataemia or anaemia influence 2,3-DPG, and whether there is any net effect on in vivo P50. Twenty healthy, non-smoking, male volunteers were compared with 20 male intensive care patients with APACHE 2 scores > 20 on the preceding day. Those transfused in this time were excluded. Venous red cell 2,3-DPG concentrations were measured in both groups. In the patient group, routine multichannel biochemical profile and arterial blood gas analysis were also performed and in vivo P50 calculated. The mean 2,3-DPG concentration was significantly lower in the patient group than in the controls (4.2 +/-1.3 mmoll/l vs 4.9 +/-0.5 mmol/l, P=0.016). The patients were well oxygenated (lowest arterial PO2=75 mm Hg) and showed a tendency to acidaemia (median pH 7.37, range 7.06 to 7.48) and anaemia (median haemoglobin concentration 113 g/l, range 89 to 154 g/l). By linear regression of patient data, pH had a significant effect on 2,3-DPG concentrations (r=0.6, P=0.011). Haemoglobin and phosphate concentrations did not, but there were few abnormal phosphate values. There was no correlation between 2,3-DPG concentrations and in vivo P50 (r(2) less than or equal to 0.08). We conclude that 2,3-DPG concentrations were reduced in a broad group of critically ill patients. Although this would normally reduce the P50, the reduction was primarily linked with acidaemia, which increases the P50. Overall, there was no net effect on the P50 and thus no affinity-related decrease in tissue oxygenation.

Mortality due to cardiovascular disease in women during the reproductive age (15 to 49 years), in the State of São Paulo, Brazil, from 1991 to 1995

OBJECTIVE: To describe mortality due to cardiovascular diseases in women during the reproductive age (15 to 49 years) in the state of São Paulo, Brazil, from 1991 to 1995. METHODS: A list of all deaths and their underlying causes, coded according to the International Classification of Diseases, 9th revision, multiple causes of death, and estimates of the female population according to age groups were provided by the SEADE Foundation. Specific coefficients for 100 thousand women for each year as well as the medians of these coefficients related to 5 years, and the percentage of death by subgroups were calculated. RESULTS: Cerebrovascular diseases have the highest coefficients (14.24 for 100 thousand females), followed by ischemic heart disease (7.37), other heart diseases (6.39), hypertensive disease (3.03), chronic rheumatic heart disease (1.58), pulmonary vascular diseases (1.29), and active rheumatic fever (0.05). Systemic arterial hypertension, as an associated cause, occurred in 55.3% to 57.8% of all the deaths due to intracerebral hemorrhage and in 30.4% to 30.8% due to subarachnoid hemorrhage. CONCLUSION: The significance of cerebrovascular diseases, coronary artery disease, and systemic arterial hypertension as causes of mortality suggests the need to emphasize preventive actions for young women who have the potential to reproduce to avoid possible complications in future pregnancies, and premature mortality.

Vemurafenib in patients with BRAF(V600) mutation-positive melanoma with symptomatic brain metastases: final results of an open-label pilot study.

BACKGROUND & AIM: Brain metastases are frequent in patients with metastatic melanoma, indicating poor prognosis. We investigated the BRAF kinase inhibitor vemurafenib in patients with advanced melanoma with symptomatic brain metastases. METHODS: This open-label trial assessed vemurafenib (960mg twice a day) in patients with BRAF(V600) mutation-positive metastatic melanoma with non-resectable, previously treated brain metastases. The primary end-point was safety. Secondary end-points included best overall response rate, and progression-free and overall survival. RESULTS: Twenty-four patients received vemurafenib for a median treatment duration of 3.8 (0.1-11.3) months. The majority of discontinuations were due to disease progression (n=22). Twenty-three of 24 patients reported at least one adverse event (AE). Grade 3 AEs were reported in four (17%; 95% confidence interval [CI], 4.7-37.4%) patients and included cutaneous squamous cell carcinoma in four patients. Median progression-free survival was 3.9 (95% CI, 3.0-5.5) months, and median survival was 5.3 (95% CI, 3.9-6.6) months. An overall partial response (PR) at both intracranial and extracranial sites was achieved in 10 of 24 (42%; 95% CI, 22.1-63.4) evaluable patients, with stable disease in nine (38%; 95% CI, 18.8-59.4) patients. Of 19 patients with measurable intracranial disease, seven (37%) achieved >30% intracranial tumour regression, and three (16%; 95% CI, 3.4-39.6%) achieved a confirmed PR. Other signs of improvement included reduced need for corticosteroids and enhanced performance status. CONCLUSIONS: Vemurafenib can be safely used in patients with advanced symptomatic melanoma that has metastasised to the brain and can result in meaningful tumour regression.

Impact of tight glycemic control on cerebral glucose metabolism after severe brain injury: a microdialysis study.

OBJECTIVES: To analyze the effect of tight glycemic control with the use of intensive insulin therapy on cerebral glucose metabolism in patients with severe brain injury. DESIGN: Retrospective analysis of a prospective observational cohort. SETTING: University hospital neurologic intensive care unit. PATIENTS: Twenty patients (median age 59 yrs) monitored with cerebral microdialysis as part of their clinical care. INTERVENTIONS: Intensive insulin therapy (systemic glucose target: 4.4-6.7 mmol/L [80-120 mg/dL]). MEASUREMENTS AND MAIN RESULTS: Brain tissue markers of glucose metabolism (cerebral microdialysis glucose and lactate/pyruvate ratio) and systemic glucose were collected hourly. Systemic glucose levels were categorized as within the target "tight" (4.4-6.7 mmol/L [80-120 mg/dL]) vs. "intermediate" (6.8-10.0 mmol/L [121-180 mg/dL]) range. Brain energy crisis was defined as a cerebral microdialysis glucose <0.7 mmol/L with a lactate/pyruvate ratio >40. We analyzed 2131 cerebral microdialysis samples: tight systemic glucose levels were associated with a greater prevalence of low cerebral microdialysis glucose (65% vs. 36%, p < 0.01) and brain energy crisis (25% vs.17%, p < 0.01) than intermediate levels. Using multivariable analysis, and adjusting for intracranial pressure and cerebral perfusion pressure, systemic glucose concentration (adjusted odds ratio 1.23, 95% confidence interval [CI] 1.10-1.37, for each 1 mmol/L decrease, p < 0.001) and insulin dose (adjusted odds ratio 1.10, 95% CI 1.04-1.17, for each 1 U/hr increase, p = 0.02) independently predicted brain energy crisis. Cerebral microdialysis glucose was lower in nonsurvivors than in survivors (0.46 +/- 0.23 vs. 1.04 +/- 0.56 mmol/L, p < 0.05). Brain energy crisis was associated with increased mortality at hospital discharge (adjusted odds ratio 7.36, 95% CI 1.37-39.51, p = 0.02). CONCLUSIONS: In patients with severe brain injury, tight systemic glucose control is associated with reduced cerebral extracellular glucose availability and increased prevalence of brain energy crisis, which in turn correlates with increased mortality. Intensive insulin therapy may impair cerebral glucose metabolism after severe brain injury.

Long-lasting antidiabetic effect of a dipeptidyl peptidase IV-resistant analog of glucagon-like peptide-1.

Glucagon-like peptide-1(7-37) (GLP-1) is the most potent insulinotropic hormone characterized thus far. Because its activity is preserved in non-insulin-dependent diabetes mellitus (NIDDM) patients, it is considered a potential new drug for the treatment of this disease. One limitation in its therapeutic use is a short half-life in vivo (5 minutes), due in part to a fast degradation by the endoprotease dipeptidylpeptidase IV (DPPIV). Recently, it was reported that GLP-1 became resistant to DPPIV when the alanine residue at position 8 was replaced by a glycine (GLP-1-Gly8). We report here that this change slightly decreased the affinity of the peptide for its receptor (IC50, 0.41 +/- 0.14 and 1.39 +/- 0.61 nmol/L for GLP-1 and GLP-1-Gly8, respectively) but did not change the efficiency to stimulate accumulation of intracellular cyclic adenosine monophosphate (cAMP) (EC50, 0.25 +/- 0.05 and 0.36 +/- 0.06 nmol/L for GLP-1 and GLP-1-Gly8, respectively). Second, we demonstrate for the first time that this mutant has an improved insulinotropic activity compared with the wild-type peptide when tested in vivo in an animal model of diabetes. A single injection of 0.1 nmol GLP-1-Gly8 in diabetic mice fed a high-fat diet can correct fasting hyperglycemia and glucose intolerance for several hours, whereas the activity of 1 nmol GLP-1 vanishes a few minutes after injection. These actions were correlated with increased insulin and decreased glucagon levels. Interestingly, normoglycemia was maintained over a period that was longer than the predicted peptide half-life, suggesting a yet undescribed long-term effect of GLP-1-Gly8. GLP-1-Gly8 thus has a markedly improved therapeutic potential compared with GLP-1, since it can be used at much lower doses and with a more flexible schedule of administration.

Citogenética do javali em criatórios comerciais das regiões Sul e Sudeste do Brasil

O desenvolvimento da criação de javalis no Brasil encontra dificuldades tais como a obtenção de animais puros (2n = 36), isto é, que não sejam descendentes do cruzamento do javali com o porco doméstico. Os objetivos deste trabalho foram a caracterização citogenética do javali (Sus scrofa scrofa L.) e a determinação da freqüência cariotípica dos diferentes grupos genéticos. Foram estudados um total de 1.308 javalis de três grupos genéticos provenientes de criatórios comerciais das regiões Sul e Sudeste do Brasil, de ambos os sexos e com idade entre 5,5 a 30 meses. Os animais apresentaram número diplóide (2n) de 36 cromossomos (46,71%), de 37 (39,68%) e de 38 cromossomos (13,61%). Os dados foram submetidos à análise estatística por meio do Teste Exato de Fisher. Na técnica de bandamento C, todos os cromossomos dos animais analisados dos três números diplóides apresentaram banda C positiva na região do centrômero e apenas o cromossomo Y mostrou-se quase inteiramente heterocromático. Já no bandamento NOR, dois pares de metacêntricos foram corados nas constrições secundárias próximas ao centrômero, correspondendo aos pares 7 e 10 nos animais 2n = 36, 37 e 38. A presença de um cromossomo submetacêntrico médio t (15; 17), formado por fusão robertsoniana nos animais com 2n = 37 pode diferenciar javalis híbridos, puros e javaporcos, visto que são fenotipicamente muito parecidos.

Angiotensin-(1-7) improves the post-ischemic function in isolated perfused rat hearts

We evaluated the effects of angiotensin-(1-7) (Ang-(1-7)) on post-ischemic function in isolated hearts from adult male Wistar rats perfused according to the Langendorff technique. Local ischemia was induced by coronary ligation for 15 min. After ischemia, hearts were reperfused for 30 min. Addition of angiotensin II (Ang II) (0.20 nM, N = 10) or Ang-(1-7) (0.22 nM, N = 10) to the Krebs-Ringer perfusion solution (KRS) before the occlusion did not modify diastolic or systolic tension, heart rate or coronary flow (basal values for Ang-(1-7)-treated hearts: 0.72 ± 0.08 g, 10.50 ± 0.66 g, 216 ± 9 bpm, 5.78 ± 0.60 ml/min, respectively). During the period of occlusion, the coronary flow, heart rate and systolic tension decreased (values for Ang-(1-7)-treated hearts: 2.83 ± 0.24 ml/min, 186 ± 7 bpm, 6.95 ± 0.45 g, respectively). During reperfusion a further decrease in systolic tension was observed in control (4.95 ± 0.60 g) and Ang II-treated hearts (4.35 ± 0.62 g). However, in isolated hearts perfused with KRS containing Ang-(1-7) the further reduction of systolic tension during the reperfusion period was prevented (7.37 ± 0.68 g). The effect of Ang-(1-7) on the systolic tension was blocked by the selective Ang-(1-7) antagonist A-779 (2 nM, N = 9), by the bradykinin B2 antagonist HOE 140 (100 nM, N = 10), and by indomethacin pretreatment (5 mg/kg, ip, N = 8). Pretreatment with L-NAME (30 mg/kg, ip, N = 8) did not change the effect of Ang-(1-7) on systolic tension (6.85 ± 0.61 g). These results show that Ang-(1-7) at low concentration (0.22 nM) improves myocardial function (systolic tension) in ischemia/reperfusion through a receptor-mediated mechanism involving release of bradykinin and prostaglandins.

Acute effect of amiodarone on cardiovascular reflexes of normotensive and renal hypertensive rats

The aim of the present study was to evaluate the effect of amiodarone on mean arterial pressure (MAP), heart rate (HR), baroreflex, Bezold-Jarisch, and peripheral chemoreflex in normotensive and chronic one-kidney, one-clip (1K1C) hypertensive rats (N = 9 to 11 rats in each group). Amiodarone (50 mg/kg, iv) elicited hypotension and bradycardia in normotensive (-10 ± 1 mmHg, -57 ± 6 bpm) and hypertensive rats (-37 ± 7 mmHg, -39 ± 19 bpm). The baroreflex index (deltaHR/deltaMAP) was significantly attenuated by amiodarone in both normotensive (-0.61 ± 0.12 vs -1.47 ± 0.14 bpm/mmHg for reflex bradycardia and -1.15 ± 0.19 vs -2.63 ± 0.26 bpm/mmHg for reflex tachycardia) and hypertensive rats (-0.26 ± 0.05 vs -0.72 ± 0.16 bpm/mmHg for reflex bradycardia and -0.92 ± 0.19 vs -1.51 ± 0.19 bpm/mmHg for reflex tachycardia). The slope of linear regression from deltapulse interval/deltaMAP was attenuated for both reflex bradycardia and tachycardia in normotensive rats (-0.47 ± 0.13 vs -0.94 ± 0.19 ms/mmHg and -0.80 ± 0.13 vs -1.11 ± 0.13 ms/mmHg), but only for reflex bradycardia in hypertensive rats (-0.15 ± 0.02 vs -0.23 ± 0.3 ms/mmHg). In addition, the MAP and HR responses to the Bezold-Jarisch reflex were 20-30% smaller in amiodarone-treated normotensive or hypertensive rats. The bradycardic response to peripheral chemoreflex activation with intravenous potassium cyanide was also attenuated by amiodarone in both normotensive (-30 ± 6 vs -49 ± 8 bpm) and hypertensive rats (-34 ± 13 vs -42 ± 10 bpm). On the basis of the well-known electrophysiological effects of amiodarone, the sinus node might be the responsible for the attenuation of the cardiovascular reflexes found in the present study.

The decreased oxygen uptake during progressive exercise in ischemia-induced heart failure is due to reduced cardiac output rate

We tested the hypothesis that the inability to increase cardiac output during exercise would explain the decreased rate of oxygen uptake (VO2) in recent onset, ischemia-induced heart failure rats. Nine normal control rats and 6 rats with ischemic heart failure were studied. Myocardial infarction was induced by coronary ligation. VO2 was measured during a ramp protocol test on a treadmill using a metabolic mask. Cardiac output was measured with a flow probe placed around the ascending aorta. Left ventricular end-diastolic pressure was higher in ischemic heart failure rats compared with normal control rats (17 ± 0.4 vs 8 ± 0.8 mmHg, P = 0.0001). Resting cardiac index (CI) tended to be lower in ischemic heart failure rats (P = 0.07). Resting heart rate (HR) and stroke volume index (SVI) did not differ significantly between ischemic heart failure rats and normal control rats. Peak VO2 was lower in ischemic heart failure rats (73.72 ± 7.37 vs 109.02 ± 27.87 mL min-1 kg-1, P = 0.005). The VO2 and CI responses during exercise were significantly lower in ischemic heart failure rats than in normal control rats. The temporal response of SVI, but not of HR, was significantly lower in ischemic heart failure rats than in normal control rats. Peak CI, HR, and SVI were lower in ischemic heart failure rats. The reduction in VO2 response during incremental exercise in an ischemic model of heart failure is due to the decreased cardiac output response, largely caused by depressed stroke volume kinetics.

Ordonnances des rois Philippe le Long, Philippe VI, Charles VI, Charles VII et Louis XI sur les matières bénéficiales et sur le domaine. Copies.

Contient : 1 Acte de CHARLES VI, du 6 octobre 1385. En latin. « Pour la reparation des edifices des eglises » ; 2 Acte de CHARLES VII. Chinon, 10 mars 1431. « Nul de quelque estat et dignité, prérogative, preeminence ou auctorité qu'il soit, ne sera receu à tenir et avoir le gouvernement ou administracion d'aucun archeveschiéz (sic), eveschié, abbaye, dignité, prieuré ou autre benefice ecclesiastique en nostredict royaume et seignorie, s'il n'est natif d'icellui nostre royaume, et seignorie et feal et bienveullant de nous » ; 3 Bulle de MARTIN V, du 1er mai 1429. En latin. « Comme au roy appartient de congnoistre des benefices en matiere possessoire » ; 4 Acte de CHARLES VI, du 26 mai 1404. « Nous, actendu ... les bons et aggreables services que nous ont fait et font continuelment ... nos dicts conseilliers, greffiers, notaires, advocas, procureurs et huissiers, et esperons qu'ilz nous facent, ou temps advenir, ne voulons ne entendons » que au « fait de l'aide nouvellement mis sus pour resister à l'entreprinse de Henry de Lenclaustre, soy disant roy d'Angleterre... ils soient aucunement comprins » ; 5 Acte de CHARLES VI, du 5 mars 1388-9. Défense à l'évêque d'Amiens, à son official et à ses archidiacres, de faire comparaître devant eux ceux qui, étant mariés, sont inculpés d'adultère, et de les condamner à une amende ; 6 Acte de CHARLES VI, du 30 juillet 1406. Le roi accorde aux habitants du Cambrésis d'hériter de leurs parents décédés en France; pourvu qu'il en soit de même pour les Français dont les parents décéderaient en Cambrésis ; 7 Acte de CHARLES VI, du 17 avril 1410. En faveur des membres du l'Université qui ont été pourvus de benefices « selon les statuz et ordonnances du concile », pour les garantir contre toute entreprise qui pourroit troubler leur possession ; 8 Acte de CHARLES VI, du 3 mai 1412. « Concessio quod gentes parlamenti, racione feodorum suorum, non arment se cum rege, in armata per eum facta Bicturis et alibi, contra certos subditos suos et inobedientes, ut sciebatur » ; 9 Acte de JEAN DE BROGNIER, évêque d'Ostie, cardinal de la sainte Eglise romaine, et vice-chancelier, du 1er avril 1410. En latin. « Transcriptum certarum conclusionum et cappitulorum in cappitulo Pisano factarum super facto beneficiorum durante neutralitate et alias collatorum » ; 10-14 Actes en latin de CHARLES VI ; 10 Paris, 18 février 1406. « Ordinacio super reduccione libertatum Ecclesie gallicane » ; 11 Même date. « Confirmacio arresti super exactione financiarum gencium ecclesiarum prolati » ; 12 11 septembre 1406. « Arrestum per modum provisionis super facto exaccionum curie romane » ; 13 Paris, après le 27 mars 1418. « Reductio perpetua ecclesiarum Francie et Delphinatus ad suas libertates antiquas » ; 14 Paris, 9 septembre 1418. « Revocacio reductionis ecclesiarum gallicane et Dalphinatus Viennensis ad suas libertates antiquas » ; 15 « Opposition du procureur du roy » et du parlement « à l'enterinement et publication des lectres revocatoires de celles de la reduccion de l'Eglise de France à ses anciennes libertez ». 15 février et 30 mars 1419 ; 16 « Extrait des ordonnances faictes touchant l'alienacion du domainne de la coronne de France », depuis le mois de décembre 1360 jusqu'au 18 octobre 1425 ; 17 « Ce sont les droicts de souveraineté et de ressort et autres drois roiaulx appartenans seul (sic) et pour le tout au roy nostre sire, et desquelx et deppendences d'iceulz, et de tous autres droiz royaulz et de souveraineté, qui par exprès icy ne peuvent estre exprimés, le gouverneur à ce ordonné aura la cognoissance, la garde et la conservation. Et ne soufferra que autrement en soit usé par le roy de Naverre ne par ses gens, ne par quelzconques autres ; et lesquels droiz ont esté baillés par manière d'instruction à maistre Arnaux de Lux, secretaire du roy et gouverneur dessusdict, le VIIIe jour de may mil CCC LXXII » ; 18 « C'est l'advis et instruction fait sur la conservacion des souverainetés et ressors et autres drois roiaulx appartenans au roy en la ville, baronie et rectorie de Montpellier, baillés au roy de Navarre, lesquelz drois et souverainetés sont toujours appartenans au roy en tout son roiaume, et par especial aussi ont été reservés au bail de lad. terre, laquelle instruction a esté baillée à maistre Arnault de Lar, secretaire du roy et gouverneur desd. souverainetés, le VIIIme jour de may l'an mil CCCLXXII » ; 19 Acte de PHILIPPE LE LONG, du 24 fevrier 1320-1321, par lequel il fait rentrer dans le domaine de la couronne les droits, les terres et les bâtiments que les héritiers de Pierre Le Hideux détenaient indûment ; 20 Acte de PHILIPPE VI DE VALOIS : donne un arrêt par lequel le comte de Vendôme, Bouchard, qui avait envahi à main armée les terres du comte de Blois, est condamné à raser la tour qu'il avait fait construire à Vendôme, etc. En latin. 23 janvier 1328-9 ; 21 « Lettres de nomination de la court, que prengnent les conseillers pour leurs benefices » ; 22 « Coppie des ordonnances et declaracions faictes par le roy nostre sire de ses droiz royaulx ès duchiés de Touraine, Anjou et le Maine, par la bonne et meure deliberacion de son conseil, ouquel estoient lors les seigneurs de son sang et lignage, les gens de son grant conseil et autres, pour ce assemblez, du temps de feu monseigneur le duc d'Anjou, et depuis ce observées et gardées » ; 23 « Extraict du livre et registre des plaidoiries de la court de parlement, videlicet du parlement commançant l'an mil IIIC. IIIIXX et cinq, le lendemain de la Saint Martin. Du XXIIe jour de fevrier, oud. an mil IIIC. IIIIXX et cinq. Entre messire Denis comparant, presbtre, d'une part, et M. Jehan de Chacteu, bailli de Meaulx, d'autre part », était débat à cause d'un prisonnier de Provins, que l'archevêque de Sens disait être clerc, et qu'il devait jouir du privilège de clergie, tandis que le bailli de Meaux prétendait qu'il était laic » ; 24 Autre extrait concernant les dîmes. Acte donné à Toulouse le 17 juin 1417, par « Galaubras de Panaffaco » ; 25 « Sentence entre Dame Pericte de La Rivière, dame de La Rocheguion, demanderesse et complaignante, en cas de saisine et de nouvelleté d'une part, et le conte de Joigny, defendeur et opposant oudict cas, d'autre part ». Paris, 23 septembre 1460 ; 26 Acte en latin de LOUIS XI, du premier février 1462-3. Même objet que l'acte précédent ; 27 « De regalia ». Exercice de la régale à Chartres sur l'évêché, après la mort de Philippe de Boys Giloud en 1418, jusqu'au départ des Anglais ; 28 « L'ordonnance du roy LOYS » XI « faite ... à Paris, le IXe jour de septembre, l'an mil IIIIe ; LXI ... touchant l'alienation du demainne » ; 29 Acte de CHARLES VII sur les revenus des eglises et leur emploi. Inachevé. En latin ; 30 Avis pour « monstrer clerement le pays de Waise, la ville et chasteau de Ruplemonde, ou pays et conté de Flandres, que monseigneur de Bourgongne dit estre de l'empire, estre neuement en ce royaume, et tenu à une seule foy et hommaige, avec lad. conté de Flandres, du roy nostre sire, et que les causes des terres et choses scituées et assises oud. paÿs, ville et chasteau, ont de tout temps et ancienneté acoustumé venir par appel et ressort en la court de parlement »

Recueil de pièces, originales et copies, formé par GAIGNIÈRES sur les joûtes. (1349-1493).

Lettres patentes de Jean II, duc de Normandie, 1349 (fol. 7), — Charles VI, 1389 (fol. 1), copie, — 1390 (fol, 10, 15, 54, 55), — 1391 (fol. 16, 17, 19), — 1411 (fol. 22, 23, 28, 29, 31, 33, 35, 37, 39, 41, 43, 45, 47, 50, 51, 52), — de Vendôme, vidame de Chartes, 1557 (fol. 5), copie, — avec des quittances d'Ernoul Du Chastel, 1349 (fol. 6), — Jean Le Maingre, dit Boucicaut, 1390-1411 (fol. 9, 13), — Regnault de Roye, 1390 (fol. 11, 12), — Jean, seigneur de Sempy, 1390 (fol. 14), — Guillaume Budé, maître des garnisons des vins, 1391 (fol. 20), — Charles de Bochain (fol. 24), — Jean et Chariot de Boissay (fol. 25, 26), — Chariot Boistel (fol. 27), — David de Brimeu (fol. 30), — Jacques Le Brun (fol. 32), — Antoine de Craon (fol. 34), — Bureau d'Issy (fol. 36), — Raoul de Gaucourt (fol. 38), — Charles de L'Isle (fol. 40), — Charles d'Ivry (fol. 42), — Guillaume Du Mesnil (fol. 44), — Jean de Nantouillet (fol. 46), — Guillaume de Prez (fol. 48), — Guion de La Rochefoucault (fol. 49), — Robert de Versailles (fol. 53), officiers du roi, 1411, orig. — « L'ordonnance du gage de messire Girerd d'Estavayé... et de messire Othe de Gransson, chevaliers », 1397 (fol. 57). — « Touchant aucunes joustes et tournoiz faitz en Alemaigne par l'empereur Maximiliam » (fol. 81). — « Le pas des armes de Sandricourt, » 1493, avec la reproduction de neuf miniatures (fol. 100), copies.

Estado del arte acerca de las discusiones teóricas sobre soberanía del estado y la unión monetaria europea entre 2002 - 2010. Caso: El Reino Unido

El siguiente trabajo tiene como objetivo el Estado del arte acerca de la discusión teórica de la repercusión de la unión monetaria en el principio de soberanía nacional, específicamente el caso de Gran Bretaña, ya que éste es el único país que expresa abiertamente su incertidumbre referente a algún tipo de amenaza a su soberanía. Se pretende precisar si existen criterios concluyentes, o por el contrario determinar si no hay claridad con respecto al futuro de Gran Bretaña como miembro de la unión monetaria.A partir de lo anterior, se plantean como sus propósitos particulares construir un marco conceptual acerca de la soberanía. Este estado del arte se inicia con citas de los principales autores de finales de siglo XVII y XVIII y finaliza con las posiciones conceptuales aportadas por los teóricos modernos motivados por el nacimiento de la Unión Europea como un nuevo orden político. Entre las que se citan: modelo centrico o intergubernamentalista, modelo de gobernabilidad multi-nivel, modelo neo-funcionalista y modelo federalista. Igualmente, el trabajo, busca desarrollar un marco conceptual sobre Unión Monetaria y su evolución hasta el logro de una unión fiscal europea en el periodo de 1950-2010, establecer las relaciones teóricas entre Soberanía del Estado y Unión Monetaria y por último realizar un análisis histórico hermenéutico de la Unión Europea y el caso del Reino Unido de acuerdo a las relaciones evidenciadas en los apartados teóricos entre soberanía del Estado y Unión Monetaria.

Macrodisco y glaucoma en individuos estudiados con tomografía óptica coherente

Introducción: El glaucoma representa la tercera causa de ceguera a nivel mundial y un diagnóstico oportuno requiere evaluar la excavación del nervio óptico que está relacionada con el área del mismo. Existen reportes de áreas grandes (macrodiscos) que pueden ser protectoras, mientras otros las asocian a susceptibilidad para glaucoma. Objetivo: Establecer si existe asociación entre macrodisco y glaucoma en individuos estudiados con Tomografía Optica Coherente (OCT ) en la Fundación Oftalmológica Nacional. Métodos: Estudio transversal de asociación que incluyó 25 ojos con glaucoma primario de ángulo abierto y 74 ojos sanos. A cada individuo se realizó examen oftalmológico, campo visual computarizado y OCT de nervio óptico. Se compararon por grupos áreas de disco óptico y número de macrodiscos, definidos según Jonas como un área de la media más dos desviaciones estándar y según Adabache como área ≥3.03 mm2 quien evaluó población Mexicana. Resultados: El área promedio de disco óptico fue 2,78 y 2,80 mm2 glaucoma Vs. sanos. De acuerdo al criterio de Jonas, se observó un macrodisco en el grupo sanos y según criterio de Adabache se encontraron ocho y veinticinco macrodiscos glaucoma Vs. sanos. (OR=0,92 IC95%=0.35 – 2.43). Discusión: No hubo diferencia significativa (P=0.870) en el área de disco entre los dos grupos y el porcentaje de macrodiscos para los dos grupos fue similar, aunque el bajo número de éstos no permitió concluir en términos estadísticos sobre la presencia de macrodisco y glaucoma.

Riesgo cardiovascular de trabajadores de una empresa de hidrocarburos. 2014

Objetivo: Determinar el riesgo cardiovascular de los trabajadores de una empresa de hidrocarburos (E.H) mediante la aplicación de la escala Framingham REGICOR durante el año 2014. Métodos: Se realizó un estudio descriptivo tipo corte transversal a partir de los registros de 700 trabajadores de una empresa de hidrocarburos que tenían una historia clínica laboral con información completa. Resultados: La edad promedio fue de 33,6 años (σ 9,1). Se encontró una prevalencia de HTA (1,4%), tabaquismo (5,7%), hábito de tomar licor (66,4%) y exceso de peso (61,6%). La prevalencia de hipertensión arterial y tabaquismo fue de 1.71% y 5.7% respectivamente, de hipercolesterolemia el 39,00%, de hipertrigliceridemia del 30,14% y el 20,00% de los trabajadores son obesos. El 3,00% (21) de los trabajadores fueron clasificados como de riesgo moderado de sufrir un evento isquémico o hemorrágico en un periodo de 10 años. A pesar que ningún trabajador fue clasificado como riesgo alto, se recomienda se realicen actividades tendientes a que a los trabajadores generen conciencia sobre los riesgos de desarrollar un evento cardiovascular si no se modifican los estilos de vida.