[The World's Columbian Exposition. Portfolio of views issued by the Department of photography, C.D. Arnold, chief. Chicago and St. Louis, National Chemigraph Company, 1893, 36 phot., don du marquis Davidsard en 1930]

Donateur : Davidsard (18..-18.. ; marquis)

L' arrest du Conseil d'en-haut, prononcé par le prophete royal David, contre Mazarin & les partisans. Par F.A.S.D.R.

[Mazarinade. 1649]

Reticulocyte dynamic and hemoglobin variability in hemodialysis patients treated with Darbepoetin alfa and C.E.R.A.: a randomized controlled trial.

BACKGROUND: In a simulation based on a pharmacokinetic model we demonstrated that increasing the erythropoiesis stimulating agents (ESAs) half-life or shortening their administration interval decreases hemoglobin variability. The benefit of reducing the administration interval was however lessened by the variability induced by more frequent dosage adjustments. The purpose of this study was to analyze the reticulocyte and hemoglobin kinetics and variability under different ESAs and administration intervals in a collective of chronic hemodialysis patients. METHODS: The study was designed as an open-label, randomized, four-period cross-over investigation, including 30 patients under chronic hemodialysis at the regional hospital of Locarno (Switzerland) in February 2010 and lasting 2 years. Four subcutaneous treatment strategies (C.E.R.A. every 4 weeks Q4W and every 2 weeks Q2W, Darbepoetin alfa Q4W and Q2W) were compared with each other. The mean square successive difference of hemoglobin, reticulocyte count and ESAs dose was used to quantify variability. We distinguished a short- and a long-term variability based respectively on the weekly and monthly successive difference. RESULTS: No difference was found in the mean values of biological parameters (hemoglobin, reticulocytes, and ferritin) between the 4 strategies. ESAs type did not affect hemoglobin and reticulocyte variability, but C.E.R.A induced a more sustained reticulocytes response over time and increased the risk of hemoglobin overshooting (OR 2.7, p = 0.01). Shortening the administration interval lessened the amplitude of reticulocyte count fluctuations but resulted in more frequent ESAs dose adjustments and in amplified reticulocyte and hemoglobin variability. Q2W administration interval was however more favorable in terms of ESAs dose, allowing a 38% C.E.R.A. dose reduction, and no increase of Darbepoetin alfa. CONCLUSIONS: The reticulocyte dynamic was a more sensitive marker of time instability of the hemoglobin response under ESAs therapy. The ESAs administration interval had a greater impact on hemoglobin variability than the ESAs type. The more protracted reticulocyte response induced by C.E.R.A. could explain both, the observed higher risk of overshoot and the significant increase in efficacy when shortening its administration interval.Trial registrationClinicalTrials.gov NCT01666301.

Notice d'environ 2500 estampes, diverses écoles... provenant du cabinet de M. O. C. D... / [expert] Vignères

[Vente. Estampes. 1859-11-12. Paris]

Durability of Concrete as Affected by Variations in Air and W/C Ratio, R-258, 1975

Many times during the past four years we have seen ranges in the durability factor for a single coarse aggregate source that were too great to be explained by variations in the coarse aggregate alone. The durability test (ASTM C 666 Method B) as presently used is a test of the concrete system rather than that of a particular coarse aggregate. An informal study of current durability factor data indicates that w/c ratio and/or percentage of air may be critical to beam growth and durability factor. The purpose of this project, R-258, is to determine the extent w/c ratio and air content variations have on beam growth and durability factor when other factors including coarse aggregate gradation are held constant.

Terapia nutricional precoce no trauma: após o A, B, C, D, E, a importância do F (FEED)

Um número significativo de mortes no trauma ocorre dias a semanas após a injúria inicial, sendo causado por infecções e insuficiência orgânica, relacionadas a hipercatabolismo e consequente desnutrição proteica aguda. A terapia nutricional deve ser planejada e incluída com as demais condutas de reanimação para pacientes politraumatizados e grandes queimados. A rápida aquisição de uma via para suporte nutricional é importante para inicio da terapia nutricional precoce em até 48 horas do atendimento. A via enteral é a opção preferencial no pós-operatório de pacientes traumatizado mas a via parenteral deve ser prescrita quando a enteral está contraindicada ou insuficiente. Após as medidas iniciais ditadas pelo ATLS, sintetizadas em A (air), B (breath), C (circulation), D (disability) e E (exposure), nós incluímos a letra F (feed) para enfatizar a importância do atendimento nutricional precoce no trauma.

Karta öfver Uleåborgs stad upprättad år 1886 i enlighet med af aflidne Civil-Ingenieur C. Kjerrström år 1876 öfver staden upprättade karta jemte tilläg af: G. Wilh. Liljeblad

Mittakaava laskettu janamittakaavasta

A A a b c d e f ff g h i k l m ..

Arkit: A8.

Swenske och lappeske ABC book. A A a b c d e f ff g h i k ..

Julkaisutiedot kolofonista.