Recurrence of atrial septal defect in three generations

Beginning with a patient presenting with an atrial septal defect (ASD) of the secundum type, the genealogy was identified in four affected individuals who belonged to three successive generations of the same family. The defects were visually confirmed in all individuals and were found to be anatomically similar. No other congenital malformations were present in these individuals. The genealogy was identified in 1972, when ASD recurred in two generations, and it was concluded that the mechanism of transmission was autosomal recessive. The fifth individual, identified 21 years later, and having an anomaly identical to that of the others, was the child of a couple who had no consaguinity and whose mother was a member of the previously studied genealogy. Considering the absence of phenotype in the parents and the rarity of the ASD gene in the general population, the occurrence of the uniparental disomy for this family nucleus, and the same autosomal recessive mechanism of transmission by this affected individual is possible. This study reports the familial occurrence of ASD by genetic mechanisms of transmission, emphasizing the necessity for genetic-clinical studies in members of the familial nucleus in order to detect new carriers, who usually are asymptomatic, thereby allowing for early and adequate treatment of individuals who may be affected.

Enumeratio plantarum : in Japonia sponte crescentium hucusque rite cognitarum, adjectis descriptionibus specierum pro regione novarum, quibus accedit determinatio herbarum in libris japonicis So mokou zoussetz xylographice delineatarum /

Volumen Secundum [v.2]

Initial experience in Brazil with the Helex septal occluder for percutaneous occlusion of atrial septal defects

OBJECTIVE: To evaluate the initial clinical experience with the Helex septal occluder for percutaneous closure of atrial septal defects. METHODS: Ten patients underwent the procedure, 7 patients with ostium secundum atrial septal defects (ASD) with hemodynamic repercussions and 3 patients with pervious foramen ovale (PFO) and a history of stroke. Mean age was 33.8 years and mean weight was 55.4 kg. Mean diameter by transesophageal echocardiography and mean stretched ASD diameter were 11.33 ± 3.3mm, and 15.2 ± 3.8mm, respectively. The Qp/Qs ratio was 1.9 ± 0.3 in patients with ASD. RESULTS: Eleven occluders were placed because a patient with 2 holes needed 2 devices. It was necessary to retrieve and replace 4 devices in 3 patients. We observed immediate residual shunt (< 2mm) in 4 patients with ASD, and in those with patent foramen ovale total occlusion of the defect occurred. No complications were noted, and all patients were discharged on the following day. After 1 month, 2 patients with ASD experienced trivial residual shunts (1mm). In 1 patient, we observed mild prolapse in the proximal disk in the right atrium, without consequences. CONCLUSION: The Helex septal occluder was safe and effective for occluding small to moderate atrial septal defects. Because the implantation technique is demanding, it requires specific training of the operator. Even so, small technical failures may occur in the beginning of the learning curve, but they do not involve patient safety.

Fechamento percutâneo de comunicação interatrial por punção trans-hepática

O fechamento percutâneo da comunicação interatrial (CIA) ostium secundum (OS) é procedimento bem estabelecido, sendo atualmente considerado o tratamento de escolha por seus bons resultados e sua baixa morbidade e mortalidade. O procedimento é realizado rotineiramente pela veia cava inferior (VCI). Ocasionalmente, entretanto, essa via de acesso não é possível por causa da obstrução ou da ausência congênita da VCI. Apresentaremos um caso de fechamento de CIA por punção trans-hepática decorrente de impossibilidade de uso da VCI.

Three new Nicaraguan Epidendrums / Alfonso H. Heller.

v.32:no.2(1968)

Fechamento percutâneo versus cirúrgico da comunicação interatrial em crianças e adolescentes

FUNDAMENTO: Há uma paucidade de dados comparando o método percutâneo e o cirúrgico para tratamento da comunicação interatrial tipo ostium secundum. OBJETIVOS: Análise de segurança e eficácia comparando ambos os métodos de tratamento em um hospital de excelência com vínculo com o Ministério de Saúde. MÉTODOS: Estudo observacional, prospectivo, não randomizado de duas coortes de crianças e adolescentes < 14 anos tratadas por meio do cateterismo intervencionista (grupo A) ou da cirurgia cardíaca convencional (grupo B). A coleta dos dados foi prospectiva no grupo A e retrospectiva no B. RESULTADOS: De abr/2009 a out/2011 foram alocados 75 pts no grupo A e entre jan/2006 e jan/2011 foram tratados 105 pts no grupo B. A idade e o peso dos pacientes foram maiores no grupo B e o diâmetro da comunicação interatrial do tipo ostium secundum foi semelhante entre os grupos. Sucesso técnico foi observado em todos os procedimentos e não houve óbitos. Complicações (a maioria menores) foram encontradas em 68% no grupo B e em 4% do grupo A (p < 0,001). As taxas de fluxo residual não significativo ou de oclusão total do defeito foram semelhantes nos dois grupos. A mediana de internação foi de 1,2 dias após o procedimento percutâneo e 8,4 dias após a correção cirúrgica (p < 0,001). CONCLUSÃO: Ambos os tratamentos são seguros e eficazes com ótimos desfechos, porém o tratamento percutâneo apresenta menor morbidade e tempo de internação. Tais observações embasam a visão que essa forma de tratamento deve ser, hoje em dia, o método de escolha para pacientes selecionados com CIA do tipo ostium secundum.

Spectrum of cardiac lesions associated with Isolated Cleft Mitral Valve and their impact on therapeutic choices

Abstract Background: Isolated cleft mitral valve (ICMV) may occur alone or in association with other congenital heart lesions. The aim of this study was to describe the profile of cardiac lesions associated with ICMV and their potential impact on therapeutic management. Methods: We conducted a descriptive study with data retrieved from the Congenital Heart Disease (CHD) single-center registry of our institution, including patients with ICMV registered between December 2008 and November 2014. Results: Among 2177 patients retrieved from the CHD registry, 22 (1%) had ICMV. Median age at diagnosis was 5 years (6 days to 36 years). Nine patients (40.9%) had Down syndrome. Seventeen patients (77.3%) had associated lesions, including 11 (64.7%) with accessory chordae in the left ventricular outflow tract (LVOT) with no obstruction, 15 (88.2%) had ventricular septal defect (VSD), three had secundum atrial septal defect, and four had patent ductus arteriosus. Thirteen patients (59.1%) required surgical repair. The decision to proceed with surgery was mainly based on the severity of the associated lesion in eight patients (61.5%) and on the severity of the mitral regurgitation in four patients (30.8%). In one patient, surgery was decided based on the severity of both the associated lesion and mitral regurgitation. Conclusion: Our study shows that ICMV is rare and strongly associated with Down syndrome. The most common associated cardiac abnormalities were VSD and accessory chordae in the LVOT. We conclude that cardiac lesions associated with ICMV are of major interest, since in this study patients with cardiac lesions were diagnosed earlier. The decision to operate on these patients must take into account the severity of both mitral regurgitation and associated cardiac lesions.

Tabulae s. Hieronymi.

F. Iv Titre (XVIe s.) : « Tabula super libros Jeronimi, secundum ordinem alphabeti (1). Tabula Sententiarum Jeronimi que ponuntur in Decreto (21v). » F. 2 « Abacuc interpretatur amplexus... — ... Zelans, amare se... ». F. 21v « Abraham servivit legi... — ... Xpistus quomodo negatur... »

Collectio sermonum de dominicis, de festis et de sanctis, ad usum Fratrum Minorum.

« Sermo adaptabillis b. Laurentio... Dispersit, dedit pauperibus... Quia secundum b. Dionixium in De ecclesiastica Yerarchia... » (1-2) ; — « Sermo de assumptione b. Marie... Quid hoc audio de te... Quid nos tantilly... » (2v-3), suivi d'une note à l'usage des prédicateurs : « Nota quod ne sermo sit deffectuosus... » (3) ; — « Sermo de conceptione b. Marie. Que est ista que progreditur... Karissimi, predicator evangelicus, beatitudinis eterne preco... » (3v-4v) ; — « Sermo de quatuor festis principalibus b. Marie... Que est ista que progreditur... Verba ista sunt tocius curie celestis... » (4v-5v) ; — « Sermo de Purificatione. In mansuetudine suscipite... Secundum b. Gregorium, Mor. 23... » (6-7) ; — « Sermo de b. Francischo... Cujus est ymago hec et superscriptio... Secundum b. Gregorium, omelia 30... » (7v-8v) ; — « Sermo in dominica [in Quinquagesima]. Ecce ascendimus Jerosolimam... Karissimi, sicut scitis, finis est... » (9-10) ; — [Sermo in dominica IIa post Epiphaniam] « Tu servasti vinum bonum usque adhuc... In verbis istis spiritualiter intellectus... » (10-10v) ; — « Sermo de b. Francischo. Ad ymaginem similitudinis sue... Verba ista ad litteram scripta... » (11-12) ; — « Sermo de b. Johane Baptista. Magnus es tu et faciens mirabilia... Secundum Gregorium quia tute... » (12v-13) ; — « Sermo de angelis. Inmittit angelus Domini... Sanctus ille David, acceptus de ovibus... » (13v-14) ; — « In ascensione Domini. Exultavit ut gigas... Duo sunt inter cetera Christi misteria... » (14v-16) ; — « De asumpcione Domine nostre. Ad preceptum tuum elevabitur aquila... Quia, karissimi, Mater Domini... » [FRANCISCUS DE MAYRONIS] ; cf. éd. Bâle, 1498, f. CIV-CIIIV, avec variantes (16v-18) ; — « De Maria Magdalena. Permittuntur [sic pro : Remittuntur] tibi peccata tua... Sicut solent maximi principes... » [Idem], sermon abrégé ; cf. éd. cit., f. LXXXVIIIV-XCI (18-19v) ; — « De s. Johane Evangelista. Dillectus meus michi... Ostenditur b. Johannes prout inflamatus... » [Idem], résumé ; cf. éd. cit., f. XXIX-XXIXV (20) ; — « In festo apostolorum Petri et Pauli. Accepimus gratiam et apostolatum... Gloriosissimi christiane fidei religionis... » (20v-23v) ; — « Sermo de gratia divina acquirenda. Accepimus gratiam etc. Vivat, obsecro, anima mea ... quoniam... » (24) ; — « Accepimus gratiam etc. Restat ostendere via physionomica... » (24v-26) ; — « Sermo de beatitudine, sive gloria celesti, sive in festo Omnium sanctorum. Fons sapientie verbum Dei... Ecce ego sto prope fontem... In hoc festo precipue et anno... » (26-29) ; — « De nativitate Domine nostre. Egredietur virga de radice Jesse... Percutiet terram virga... Clementissimus pastor ovium... » (29v-32) ; — « Sermo de uno confessore pontifice. Rector fratrum et stabilimentum populi... Inter viros eximie sanctitatis... » (32v) ; — « De nativitate Domini. Transeamus usque Bethelem... Innocencius in quodam sermone de predicatione... » (34v-36) ; — « In die nativitatis Domini. Sol ortus est et humiles exaltati sunt... Beatus Augustinus, De Civitate Dei : Anima participacione... » (36-37v) ; — « Dominica infra octavas Nativitatis. Ecce positus est hic in ruinam... Secundum doctrinam Philosophi in diversis locis... » (38-38v) ; — « Dominica quarta in quadragesima. Sequebatur eum multitudo magna... Secundum Damascenum libro primo, capitulo XV°, diversitas actionum... » (39-40v) ; — « De Canane[a], dominica secunda [sic] in quadragesima [Feria 5a post dom. Ia in XLa]. Dimitte illam quia clamat... Si attendamus ordinem generacionis... » (41-42v) ; — « Dominica de Passione. Si veritatem dico vobis... Secundum sententiam Phylosophi primo Metaphysice... » (43-43v) ; — « In cena Domini. Hodie est rex et cras morietur... Omne agens ordinate prius inquirit... » (44-45) ; — « De resurectione. Hec dies quam fecit Dominus... Scilicet est ex dictis Philosophi in diversis locis... » (45v-47) ; — « Dominica in Quadragesima. Ecce nunc tempus acceptabile... Ut dicit Philosophus, secundo de Celo et mundo... » (47-48v) ; — « De b. Clara. Sicut lux meridiana clara est... Secundum Philosophum tertio Methaphysice, si res creatas... » (48v-49v) ; — « Sermo de Cruce. Vidit mulier quod bonum esset lignum... Sicut ex doctrina Philosophi primo Ethicorum... » (50-51) ; — « De s. Anthonio. Misit servum suum hora cene... Sicut in rebus naturalibus docet experiencia... » (51v-52v) ; — « De b. Johane Batista. Tu puer propheta Altissimi... Secundum doctrinam Hugonis in commento de angelica Jerarchia... » (53-54) ; — « De b. Bertholameo [sic]. Dedit illi contra inimicos potenciam... Racio docet et experiencia manifestat... » (54v-55) ; — « De b. Francischo. Amice, ascende superius... Dicit Philosophus quinto Physicorum quod motus... » (55v-56) ; — [De b. Bernardo] « Omnia parata sunt, venite ad nupcias... Sicut videmus in motu naturali... » (56v-57) ; — « De sacerdote novo. Vos elegit Dominus... Ut potest haberi ex dictis Dyonisii... » (57v-58v) ; — « De assumpcione Virginis gloriose. Elevetur tronus David super Israel... Videmus quod triplici racione aliqua corpora... » (58v-59v) ; — « De assumpcione Virginis. Veni de Libano sponsa mea... Secundum testimonium Scripturarum et humane consuetudinis... » (59v-61) ; — « De Trinitate. Tripliciter sol exurens montes... Secundum quod dicit Philosophus, tota nostra noticia... » (61-61v) ; — « De b. Francischo. Hic beatus in facto suo erit... Post doctrinam philosophorum et experienciam... » (62-62v) ; — [De b. Eligio] « Provideat rex virum sapientem... Secundum sententiam (secundum) sapientis primo Metaphysice . » (63-64) ; — « De resurrectione Domini. Tercia dies est hodie... Tripliciter alicujus rei non vise accipimus fidem certam... » (64-65) ; — «Stetit in medio discipulorum et dixit : Pax vobis... Ut dicit b. Augustinus undevicesimo de Civitate Dei... » (65v-67) ; — « De Omnibus sanctis... Gloriosa dicta sunt de te... Aperta est civitas... Doctore egregio Bernardo scilicet attestante... » (67-69) ; — « De b. Johane Batista. Hic venit in testimonium... Sicut potest probari ex dictis Philosophi et exemplis... » (69v-70) ; — « De b. Petro apostolo. Tu pasce populum meum Israel... Secundum sententiam Philosophi tertio Politicorum... » (70v-71) ; — « De assumpcione Virginis gloriose. Transibo in locum tabernaculi... Triplici ratione secundum philosophorum doctrinam aliqua moventur... » (71v-72v) ; — [De b. Francisco] « Adolescens, tibi dico surge... Consideranti sciderum revolucionem... » (73-74v) ; — [De s. Michaele] « Michael et angeli preliabantur... Sicut ex doctrina Phylosophi in pluribus locis patet... » (74v-76) ; — « De b. Nicholao. Petra fundebat michi rivos olei... Secundum philosophicam doctrinam, diversitas effectuum... » (76-77) ; — « In festo apostolorum Petri et Pauli. Fecit Deus duo luminaria magna... Secundum sententiam Philosophi secundo Methaphysice... » (77v-78) ; — « De b. Bertholameo. Vidi angelum fortem... Secundum dictum Philosophi, omnes transferentes... » (78v-79) ; — « Dominica in Quadragesima. Ductus est Jhesus in desertum... Sicut naturalium operationum multiplex experiencia... » (79v-80v) ; — « De s. Thoma apostolo. Ecce cognovi quoniam Deus meus es... Bernardus in sermone : Deus noverim me... » (81-81v) ; — « De sacerdote novo. Misit Dominus servum suum... Secundum quod dicit Philosophus primo Ethicorum, diversarum operationum... » (82-82bis) ; — « In purificatione Virginis. Parasti ante faciem omnium populorum... Si attendamus formationem rerum temporalium... » (82bisv-83v) ; — « De uno martire. Esto vir fortis, et prelia bella Domini... Secundum consuetudinem hominum... » (84-85) ; — « De festo Purificacionis. Lucerna splendens super candelabrum... Doctrina philosophorum et tradit... » (85v-86v) ; — « Feria quarta Cinerum. Cum jejunas unge caput tuum... Morum Philosophi doctrinam perlegens et attendens... » (87-88v) ; — « In quarta feria Cinerum. Cum jejunatis, nolite fieri sicut ypocrite... Sicut ex doctrina Philosophi primo Ethicorum potest colligi... » (88v-89v) ; — « In festo b. Lodovici [episcopi]. Surrexit rex de solio suo... Ut dicit Philosophus quarto Methaphysicorum... » (90-91v) ; — « De b. Jacobo. Vox tonitrui tui in rota... Secundum doctrinam philosophicam formarum naturalium... » (91v-92v) ; — [In festo Annunciationis] « Ecce concipies in utero... Secundum doctrinam Philosophi septimo de Animalibus, ad generationem... » (93-94) ; — « De s. Ludovico [episcopo]. Reposita est michi corona justitie... Secundum sententiam Philosophi secundo Phisicorum, omne agens... » (94-96).

Évangile de saint Jean.

Acquis le 2 avril 1743 de madame du Faÿ parmi 11 mss. pour le prix global de 1200 livres; cf. B.n.F., département des Manuscrits, Archives Ancien Régime 65, registre des acquisitions du département des Manuscrits 1667-1758, f. 291 "n° 87. Codex evangelii secundum Joannem, litteris auro depictis"; mention de la main de l'abbé Sallier "De madame du Fay. 12" (contreplat sup.); — note du XVe s. "Iste liber emptus fuit de precio scutorum LXV (...) M° CCCC° LXV°" (contreplat sup.); — anciennes cotes "87", "17" (Cv)