Artérite de Horton: recommandations Lausannoises de prise en charge [Giant cell arteritis: guidelines of the University Hospital of Lausanne].

Giant cell arteritis (GCA) is a subacute/chronic vasculitis and represents the most common form of systemic vasculitis in people over the age of 50 years. The absence of clear and specific diagnostic criteria with the highly variable clinical presentation is a diagnostic challenge requesting a multidisciplinary approach. Yet, GCA is an emergency and the treatment must be initiated very rapidly due to the risk of blindness. This article presents a review of GCA as well as the diagnostic and therapeutic institutional guidelines of the University Hospital of Lausanne.

[Voyage en Italie : 1824-1830]. , [Maison] : [plan] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 411

Pavement Texturing by Milling, HR-283, 1987

Experience has shown that milling machines with carbide tipped teeth have the capability of profiling most asphalt concrete (ac) and portland cement concrete (pcc) pavements. Most standard milling operations today leave a very coarse, generally objectionable surface texture. This research utilized a Cedarapids Wirtgen 1900C mill modified by adding additional teeth. There were 411 teeth at a 5 millimeter transverse spacing (standard spacing is 15 mm) on a 6 ft. 4 in. long drum. The mill was used to profile and texture the surface of one ac and two pcc pavements. One year after the milling operation there is still some noticeable change in tire noise but the general appearance is good. The milling operation with the additional teeth provides an acceptable surface texture with improved Friction Numbers when compared to a nonmilled surface.

Dynamic Deflections to Determine Roadway Support Ratings, HR-245, 1983

The Benkelman Beam structural test of flexible pavements was replaced in 1976 by dynamic deflection testing with a model 400 Road Rater. The Road Rater is used to determine structural ratings of flexible pavements. New pavement construction in Iowa has decreased with a corresponding increase of restoration and rehabilitation. A method to determine structural ratings of layered systems and rigid pavements is needed to properly design overlay thickness. The objective of this research was to evaluate the feasibility of using the Road Rater to determine support values of layered systems and rigid pavements. This evaluation was accomplished by correlating the Road Rater with the Federal Highway Administration (FHWA) Thumper, a dynamic deflection testing device. Data were obtained with the Road Rater and Thumper at 411 individual test locations on 39 different structural sections ranging from 10" of PCC pavement and 25" of asphalt pavement to a newly graveled unpaved roadway. A high correlation between a 9000 pound Thumper deflection and the 1185 pound Road Rater deflection was obtained. A Road Rater modification has been completed to provide 2000 pound load inputs. The basin, defined by four sensors spaced at 1 foot intervals, resulting from the 2000 pound loading is being used to develop a graph for determining relative subgrade strengths. Road Rater deflections on rigid pavements are sufficient to support the potential for this technique.

Importância das interações cultivares x locais e cultivares x anos na avaliação de milho na safrinha

Com o objetivo de verificar a importância da interação cultivares x locais e cultivares x anos e de identificar entre os híbridos já disponíveis os que sejam mais adaptados e estáveis para o cultivo em safrinha, foram estimados os parâmetros de adaptabilidade e estabilidade a partir de dados obtidos em experimentos de avaliação de cultivares de milho na safrinha, nos anos de 1993, 1994 e 1995. Esses experimentos foram conduzidos nos Estados de São Paulo, Goiás e Paraná. O delineamento utilizado foi em blocos casualizados com três repetições. Constatou-se que a magnitude da variância da interação cultivares com anos dentro de locais foi mais expressiva do que entre locais, o que indica a necessidade de que as avaliações de cultivares na safrinha sejam realizadas num maior número de anos. As cultivares diferiram quanto à adaptabilidade e estabilidade de produção de grãos. Os materiais que se destacaram como mais adaptados e estáveis foram o híbrido simples Zeneca 8452, o híbrido triplo C 805 e o híbrido duplo Agromen 2012. Já os híbridos duplos BR 201, Planagri 411, AG 303 e C 125 foram os que mostraram menor adaptação e maior instabilidade.

Crescimento e produção de primeiro ciclo da bananeira 'Prata Anã' (AAB) em sete espaçamentos

Este estudo teve por objetivo verificar o comportamento da bananeira (Musa spp.) 'Prata Anã' no primeiro ciclo de produção na localidade de Jaíba, MG, submetida a sete espaçamentos, com irrigação. Os tratamentos foram: triângulo: 2,7 m x 3,2 m (1.157 covas/ha) e 2,9 m x 3,4 m (1.014 covas/ha); fileira dupla em triângulo: 4,5 m x 2,0 m x 3,0 m (1.026 covas/ha) e 4,5 m x 2,0 m x 2,0 m (1.538 covas/ha); fileira dupla em retângulo: 4,5 m x 2,0 m x 3,5 m (879 covas/ha); e retângulo: 4,0 m x 2,0 m (1.250 covas/ha) e 3,0 m x 2,0 m (1.666 covas/ha). Os sistemas de espaçamento e as densidades populacionais testados não alteraram as taxas de crescimento das plantas nem suas características na época da colheita. Entretanto, as bananeiras plantadas em maiores densidades apresentaram maior produtividade, atingindo até 29,1 t/ha. As plantas apresentaram, em média, ciclo do plantio à colheita de 411 dias, ciclo do florescimento à colheita de 141 dias, e cachos com 17,7 kg, 9,1 pencas e 134 frutos. Para o primeiro ciclo de produção, o espaçamento mais apropriado foi de 3,0 m x 2,0 m, em retângulo, para a região de Jaíba.

Avaliação de programas hormonais para a indução e sincronização do estro em caprinos

O objetivo deste trabalho foi estabelecer alternativas para indução e sincronização do estro em cabras leiteiras manejadas semi-intensivamente. Foram conduzidos quatro experimentos com 411 cabras na Embrapa-Centro Nacional de Pesquisa deCaprinos, Sobral, CE. No protocolo básico, utilizaram-se esponjas intra-vaginais com 50 mg de acetato de medroxiprogesterona (MAP) por dez dias e aplicação intra-muscular de 100 mig de cloprostenol e 200 UI de gonadotropina coriônica eqüina (eCG) no 8º dia; a inseminação artificial (IA), com sêmen congelado foi feita 38 horas após remoção da esponja. No experimento1 substituiu-se a e CG pelo "efeito macho"; no experimento 2 substituiu-se a dose de MAP para 60 mg; no experimento3 compararam-se diferentes momentos de IA: 38, 44 e 50 horas e no experimento 4 substituiu-se a eCG pela gonadotropina humana (hCG). Nenhuma das alternativas testadas modificou (P>0,05) a prolificidade. A IA em cio natural gerou maior (P<0,05) índice de parição no experimento2(67,7%) e no experimento 4 (73,3%). A dose de 60 mg de MAP permitiu realizar a IA mais tarde (44 horas apósretirar a esponja) sem detrimento da fertilidade. A hCG equivaleu a eCG, se aplicada 48 horas antes de retirar a esponja.

Surface-to-air signals.

Powerful volatile regulators of gene expression, pheromones and other airborne signals are of great interest in biology. Plants are masters of volatile production and release, not just from flowers and fruits, but also from vegetative tissues. The controlled release of bouquets of volatiles from leaves during attack by herbivores helps plants to deter herbivores or attract their predators, but volatiles have other roles in development and in the control of defence gene expression. Some of these roles may include long-distance signalling within and perhaps between plants.

Allergy to betalactam antibiotics in children: results of a 20-year study based on clinical history, skin and challenge tests.

To cite this article: Ponvert C, Perrin Y, Bados-Albiero A, Le Bourgeois M, Karila C, Delacourt C, Scheinmann P, De Blic J. Allergy to betalactam antibiotics in children: results of a 20-year study based on clinical history, skin and challenge tests. Pediatr Allergy Immunol 2011; 22: 411-418. ABSTRACT: Studies based on skin and challenge tests have shown that 12-60% of children with suspected betalactam hypersensitivity were allergic to betalactams. Responses in skin and challenge tests were studied in 1865 children with suspected betalactam allergy (i) to confirm or rule out the suspected diagnosis; (ii) to evaluate diagnostic value of immediate and non-immediate responses in skin and challenge tests; (iii) to determine frequency of betalactam allergy in those children, and (iv) to determine potential risk factors for betalactam allergy. The work-up was completed in 1431 children, of whom 227 (15.9%) were diagnosed allergic to betalactams. Betalactam hypersensitivity was diagnosed in 50 of the 162 (30.9%) children reporting immediate reactions and in 177 of the 1087 (16.7%) children reporting non-immediate reactions (p < 0.001). The likelihood of betalactam hypersensitivity was also significantly higher in children reporting anaphylaxis, serum sickness-like reactions, and (potentially) severe skin reactions such as acute generalized exanthematic pustulosis, Stevens-Johnson syndrome, and drug reaction with systemic symptoms than in other children (p < 0.001). Skin tests diagnosed 86% of immediate and 31.6% of non-immediate sensitizations. Cross-reactivity and/or cosensitization among betalactams was diagnosed in 76% and 14.7% of the children with immediate and non-immediate hypersensitivity, respectively. The number of children diagnosed allergic to betalactams decreased with time between the reaction and the work-up, probably because the majority of children with severe and worrying reactions were referred for allergological work-up more promptly than the other children. Sex, age, and atopy were not risk factors for betalactam hypersensitivity. In conclusion, we confirm in numerous children that (i) only a few children with suspected betalactam hypersensitivity are allergic to betalactams; (ii) the likelihood of betalactam allergy increases with earliness and/or severity of the reactions; (iii) although non-immediate-reading skin tests (intradermal and patch tests) may diagnose non-immediate sensitizations in children with non-immediate reactions to betalactams (maculopapular rashes and potentially severe skin reactions especially), the diagnostic value of non-immediate-reading skin tests is far lower than the diagnostic value of immediate-reading skin tests, most non-immediate sensitizations to betalactams being diagnosed by means of challenge tests; (iv) cross-reactivity and/or cosensitizations among betalactams are much more frequent in children reporting immediate and/or anaphylactic reactions than in the other children; (v) age, sex and personal atopy are not significant risk factors for betalactam hypersensitivity; and (vi) the number of children with diagnosed allergy to betalactams (of the immediate-type hypersensitivity especially) decreases with time between the reaction and allergological work-up. Finally, based on our experience, we also propose a practical diagnostic approach in children with suspected betalactam hypersensitivity.

Chronic low-frequency rTMS of primary motor cortex diminishes exercise training-induced gains in maximal voluntary force in humans.

Although there is consensus that the central nervous system mediates the increases in maximal voluntary force (maximal voluntary contraction, MVC) produced by resistance exercise, the involvement of the primary motor cortex (M1) in these processes remains controversial. We hypothesized that 1-Hz repetitive transcranial magnetic stimulation (rTMS) of M1 during resistance training would diminish strength gains. Forty subjects were divided equally into five groups. Subjects voluntarily (Vol) abducted the first dorsal interosseus (FDI) (5 bouts x 10 repetitions, 10 sessions, 4 wk) at 70-80% MVC. Another group also exercised but in the 1-min-long interbout rest intervals they received rTMS [Vol+rTMS, 1 Hz, FDI motor area, 300 pulses/session, 120% of the resting motor threshold (rMT)]. The third group also exercised and received sham rTMS (Vol+Sham). The fourth group received only rTMS (rTMS_only). The 37.5% and 33.3% gains in MVC in Vol and Vol+Sham groups, respectively, were greater (P = 0.001) than the 18.9% gain in Vol+rTMS, 1.9% in rTMS_only, and 2.6% in unexercised control subjects who received no stimulation. Acutely, within sessions 5 and 10, single-pulse TMS revealed that motor-evoked potential size and recruitment curve slopes were reduced in Vol+rTMS and rTMS_only groups and accumulated to chronic reductions by session 10. There were no changes in rMT, maximum compound action potential amplitude (M(max)), and peripherally evoked twitch forces in the trained FDI and the untrained abductor digiti minimi. Although contributions from spinal sources cannot be excluded, the data suggest that M1 may play a role in mediating neural adaptations to strength training.

Tumeurs de l'appareil locomoteur: de la simple "bosse" a la prise en charge multidisciplinaire [Tumors of the musculoskeletal system: from the "lumps" to multidisciplinary care].

Management of musculoskeletal tumours usually begins with the appearance of a lump or bump, or the onset of unspecific symptoms. A poor initial work-up, a faulty biopsy or an inadequate resection may have a severe impact on the prognosis, including re-interventions, amputation, local recurrence or systemic spread of the disease. The patient with a suspicious lesion should be referred to a "sarcoma centers" where a planned and well-performed diagnostic work-up will allow a precise diagnosis in terms of histology and staging. After a multidisciplinary discussion of the case, an accurate treatment plan is established. Such an approach allows an adequate patient management, often with a positive impact on the survival and functional outcome.