Les ruines de Paris. Tome 2 / par Charles Monselet

Collection : Collection Hetzel

Les ruines de Paris. Tome 1 / par Charles Monselet

Collection : Collection Hetzel

The human T cell response to melanoma antigens.

The cornerstone of the concept of immunosurveillance in cancer should be the experimental demonstration of immune responses able to alter the course of in vivo spontaneous tumor progression. Elegant genetic manipulation of the mouse immune system has proved this tenet. In parallel, progress in understanding human T cell mediated immunity has allowed to document the existence in cancer patients of naturally acquired T cell responses to molecularly defined tumor antigens. Various attributes of cutaneous melanoma tumors, notably their adaptability to in vitro tissue culture conditions, have contributed to convert this tumor in the prototype for studies of human antitumor immune responses. As a consequence, the first human cytolytic T lymphocyte (CTL)-defined tumor antigen and numerous others have been identified using lymphocyte material from patients bearing this tumor, detailed analyses of specific T cell responses have been reported and a relatively large number of clinical trials of vaccination have been performed in the last 15 years. Thus, the "melanoma model" continues to provide valuable insights to guide the development of clinically effective cancer therapies based on the recruitment of the immune system. This chapter reviews recent knowledge on human CD8 and CD4 T cell responses to melanoma antigens.

Comportamento de linhagens de sorgo forrageiro submetidas a déficit hídrico sob condição controlada

O objetivo deste trabalho foi avaliar os efeitos do estresse hídrico no estabelecimento, desenvolvimento e na taxa de sobrevivência de 11 linhagens de sorgo forrageiro em casa de vegetação. O delineamento experimental foi o de blocos ao acaso no arranjo de parcelas subdivididas no tempo, com cinco repetições. As unidades experimentais foram constituídas por recipientes de 250 L, onde foram colocados 187,9 kg de solo da classe textural areia franca. O estudo compreendeu dois períodos de estresse, e três irrigações, sendo uma no início e as outras aplicadas quando grande número de folhas tinham aspecto de palha seca. No primeiro período, as linhagens apresentaram alta taxa de sobrevivência, demonstrando resistência ao estresse hídrico. As linhagens que apresentaram menor velocidade de crescimento nesse período sofreram menos com o estresse. No segundo período não ocorreram diferenças significativas entre as linhagens com relação ao desenvolvimento das plantas. Durante os dois períodos de estresse, a velocidade de crescimento não diferenciou satisfatoriamente linhagens de comportamento distintos, quanto à resistência à seca, competindo em um mesmo recipiente e em alta densidade populacional. As linhagens 84, 29, 99, 41, 63 e 104 apresentaram maior resistência ao estresse hídrico e as linhagens 33, 38, 40, 67 e 92, menor resistência.

Quantitative ultrasound in the management of osteoporosis: the 2007 ISCD Official Positions

Dual-energy X-ray absorptiometry (DXA) is commonly used in the care of patients for diagnostic classification of osteoporosis, low bone mass (osteopenia), or normal bone density; assessment of fracture risk; and monitoring changes in bone density over time. The development of other technologies for the evaluation of skeletal health has been associated with uncertainties regarding their applications in clinical practice. Quantitative ultrasound (QUS), a technology for measuring properties of bone at peripheral skeletal sites, is more portable and less expensive than DXA, without the use of ionizing radiation. The proliferation of QUS devices that are technologically diverse, measuring and reporting variable bone parameters in different ways, examining different skeletal sites, and having differing levels of validating data for association with DXA-measured bone density and fracture risk, has created many challenges in applying QUS for use in clinical practice. The International Society for Clinical Densitometry (ISCD) 2007 Position Development Conference (PDC) addressed clinical applications of QUS for fracture risk assessment, diagnosis of osteoporosis, treatment initiation, monitoring of treatment, and quality assurance/quality control. The ISCD Official Positions on QUS resulting from this PDC, the rationale for their establishment, and recommendations for further study are presented here.

A simple score for estimating ischemic heart disease in patients with non-traumatic chest pain in primary care

Background: Modelling epidemiological knowledge in validated clinical scores is a practical mean of integrating EBM to usual care. Existing scores about cardiovascular disease have been largely developed in emergency settings, but few in primary care. Such a toll is needed for general practitioners (GP) to evaluate the probability of ischemic heart disease (IHD) in patients with non-traumatic chest pain. Objective: To develop a predictive model to use as a clinical score for detecting IHD in patients with non-traumatic chest-pain in primary care. Methods: A post-hoc secondary analysis on data from an observational study including 672 patients with chest pain of which 85 had IHD diagnosed by their GP during the year following their inclusion. Best subset method was used to select 8 predictive variables from univariate analysis and fitted in a multivariate logistic regression model to define the score. Reliability of the model was assessed using split-group method. Results: Significant predictors were: age (0-3 points), gender (1 point), having at least one cardiovascular risks factor (hypertension, dyslipidemia, diabetes, smoking, family history of CVD; 3 points), personal history of cardiovascular disease (1 point), duration of chest pain from 1 to 60 minutes (2 points), substernal chest pain (1 point), pain increasing with exertion (1 point) and absence of tenderness at palpation (1 point). Area under the ROC curve for the score was of 0.95 (IC95% 0.93; 0.97). Patients were categorised in three groups, low risk of IHD (score under 6; n = 360), moderate risk of IHD (score from 6 to 8; n = 187) and high risk of IHD (score from 9-13; n = 125). Prevalence of IHD in each group was respectively of 0%, 6.7%, 58.5%. Reliability of the model seems satisfactory as the model developed from the derivation set predicted perfectly (p = 0.948) the number of patients in each group in the validation set. Conclusion: This clinical score based only on history and physical exams can be an important tool in the practice of the general physician for the prediction of ischemic heart disease in patients complaining of chest pain. The score below 6 points (in more than half of our population) can avoid demanding complementary exams for selected patients (ECG, laboratory tests) because of the very low risk of IHD. Score above 6 points needs investigation to detect or rule out IHD. Further external validation is required in ambulatory settings.

Oral English in different school settings

Hi ha molts tipus d’escoles diferents, i fins i tot, podem constatar que cada escola és diferent de les altres. Per aquesta raó, quan parlem sobre l’aprenentatge de l’anglès, no podem generalitzar una manera de fer-ho, perquè cada una d’elles tracta aquesta llengua de manera diferent. A més, pel que fa a l’aprenentatge d’una llengua, hi ha diferents habilitats involucrades, i entre totes aquestes, he centrat aquest projecte en l’habilitat oral. Aquesta recerca esta basada en l’observació de tres exemples de tipus d’escoles, i per ser més precisos, té l’objectiu d’aprofundir com tracten l’Anglès. D’aquesta manera, el principal objectiu d’aquest projecte és comparar l’habilitat oral dels alumnes d’aquestes escoles, tot considerant les seves diferències. Així doncs, amb el desenvolupament d’aquesta recerca, vaig voler descobrir si hi havien alguns alumnes amb millors habilitats orals que d’altres, i trobar-ne la possible raó.

Knochenanabole Therapie mit Teriparatid [Bone anabolic treatment with Teriparatide].

The recombinant amino-terminal fragment of human parathyroid hormone (Teriparatide) is a bone anabolic agent which reduces fracture risk by increasing bone mass and improving bone microarchitecture. Teriparatide reduces vertebral fracture risk by 65 % and non-vertebral by 50 %. Its efficacy is higher as bisphosphonates to prevent corcicosteroid-induced osteoporosis. Teriparatide may also have a direct effect on bone pain. Teriparatide may be initiating immediately after an anticatabolic agent. However, it is not recommended to associate both treatments. At the end of teripatide treatment, an anticatabolic agent may be given. According to cost-effectiveness studies, Teriparatide should be considered as first line treatment for postmenopausal women and for men with severe osteoporosis.

Electrical stimulation induces propagated colonic contractions in an experimental model.

BACKGROUND: Direct colonic electrical stimulation may prove to be a treatment option for specific motility disorders such as chronic constipation. The aim of this study was to provoke colonic contractions using electrical stimulation delivered from a battery-operated device. METHODS: Electrodes were inserted into the caecal seromuscular layer of eight anaesthetized pigs. Contractions were induced by a neurostimulator (Medtronic 3625). Caecal motility was measured simultaneously by video image analysis, manometry and a technique assessing colonic transit. RESULTS: Caecal contractions were generated using 8-10 V amplitude, 1000 micros pulse width, 120 Hz frequency for 10-30 s, with an intensity of 7-15 mA. The maximal contraction strength was observed after 20-25 s. Electrical stimulation was followed by a relaxation phase of 1.5-2 min during which contractions propagated orally and aborally over at least 10 cm. Spontaneous and stimulated caecal motility values were significantly different for both intraluminal pressure (mean(s.d.) 332(124) and 463(187) mmHg respectively; P < 0.001, 42 experiments) and movement of contents (1.6(0.9) and 3.9(2.8) mm; P < 0.001, 40 experiments). CONCLUSION: Electrical stimulation modulated caecal motility, and provoked localized and propagated colonic contractions.

Recueil d'actes intéressant la sénéchaussée de Beaucaire, de saint Louis à Philippe de Valois ; poème sur le comput .

Contient au f. 23 un poème sur le comput : L'escriptura mostra per ver, Que Dieus dona sen e saber [...]. Récolé le 8 mai 1877.