Pulmonary hypertension in lymphangioleiomyomatosis: characteristics in 20 patients.

This retrospective, multicentre study evaluated patients with lymphangioleiomyomatosis (LAM) and pre-capillary pulmonary hypertension (PH) by right heart catheterisation. It was conducted in 20 females with a mean ± SD age of 49 ± 12 yrs and a mean ± SD time interval between LAM and PH diagnoses of 9.2 ± 9.8 yrs. All, except for one patient, were receiving supplemental oxygen. 6-min walking distance was mean ± SD 340 ± 84 m. Haemodynamic characteristics were: mean pulmonary artery pressure (PAP) 32 ± 6 mmHg, cardiac index 3.5 ± 1.1 L · min(-1) · m(-2) and pulmonary vascular resistance (PVR) 376 ± 184 dyn · s · cm(-5). Mean PAP was >35 mmHg in only 20% of cases. The forced expiratory volume in 1 s was 42 ± 25%, carbon monoxide transfer factor was 29 ± 13%, and arterial oxygen tension (P(a,O(2))) was 7.4 ± 1.3 kPa in room air. Mean PAP and PVR did not correlate with P(a,O(2)). In six patients who received oral pulmonary arterial hypertension (PAH) therapy, the PAP decreased from 33 ± 9 mmHg to 24 ± 10 mmHg and the PVR decreased from 481 ± 188 dyn · s · cm(-5) to 280 ± 79 dyn · s · cm(-5). The overall probability of survival was 94% at 2 yrs. Pre-capillary PH of mild haemodynamic severity may occur in patients with LAM, even with mild pulmonary function impairment. PAH therapy might improve the haemodynamics in PH associated with LAM.

Executive Order Number Sixteen, August 20, 2009

This Executive Order expects the State government to envision an economic future for the State of Iowa in which its citizens will leak the nation toward the clean, safe, unlimited, efficient job producing prosperity-inducing and environmentally friendly energies of the 21st Century (sometimes referred to as a "Green Economy').

Cumulative risk factors for adolescent alcohol misuse and its perceived consequences among 16 to 20 year old adolescents in Switzerland.

AIMS: To assess the cumulative impact of environmental and individual factors associated with adolescent alcohol misuse and their correlation with self-reported consequences of drinking. METHOD: Cross-sectional school-based survey of a nationally representative sample of 7548 post-mandatory school students and apprentices aged 16-20 years, Switzerland 2002. Alcohol misuse defined by frequency of alcohol use, episodes of drunkenness and driving while drunk. RESULTS: Fifteen significant risk factors were identified among both boys, and girls. An individual score of cumulated risk factors was created by adding the risk factors. The association between the score and the likelihood of being engaged in alcohol misuse was highly significant and dose-dependent (p<.001). A significant proportion of adolescents report perceived adverse consequences of their alcohol consumption. A linear trend (p<.001) was found between the score of risk factors and the proportion of respondents reporting problems related to drinking such as diminished school performance, physical hazard, relational problems and current risky sexual behavior. CONCLUSION: Risk factors for adolescent alcohol misuse are cumulative and can be synthesized into an individual score correlated with the likeliness of misuse. A further indication of the validity of this score is its linear relationship with self-reported problems related to drinking.

Registre des dépêches adressées à la Cour, principalement à Henri-Auguste de Loménie de Brienne, à Mazarin et à Hugues de Lionne, par Antoine DE LUMBRES, seigneur d'Herbinghem, ambassadeur en Allemagne et en Pologne. Minutes. (1652 et 1655-1666.). I 20 décembre 1652, et juin 1655-29 avril 1659.

On remarque (f. 119-131) un fragment de registre de maintenue de noblesse, pour le Cotentin, fin novembre-8 décembre 1598, anciennement paginé 31-56, copie du XVIIe siècle.

Fiscal Update, January 20, 1998

The Fiscal Division newsletter, published weekly during session and periodically during the interim.

Fiscal Update, January 20, 1998

The Fiscal Division newsletter, published weekly during session and periodically during the interim.

Fiscal Update, January 20, 1998

The Fiscal Division newsletter, published weekly during session and periodically during the interim.

Fiscal Update, April 20, 1998

The Fiscal Division newsletter, published weekly during session and periodically during the interim.

Fiscal Update, July 20, 1998

The Fiscal Division newsletter, published weekly during session and periodically during the interim.

Fiscal Update, November 20, 1998

The Fiscal Division newsletter, published weekly during session and periodically during the interim.

Fiscal Update, July 20, 1999

The Fiscal Division newsletter, published weekly during session and periodically during the interim.

Fiscal Update, March 20, 2000

The Fiscal Division newsletter, published weekly during session and periodically during the interim.