Intravitreal ranibizumab in the treatment of choroidal neovascularization associated with idiopathic central serous chorioretinopathy.

PURPOSE: We evaluate the functional and anatomic outcome after intravitreal ranibizumab treatment in patients with choroidal neovascularization (CNV) related to chronic central serous chorioretinopathy (CSC). METHODS: This is a small case series of 5 eyes with CNV associated with chronic CSC treated with intravitreal injection of 0.5 mg ranibizumab in the Jules Gonin University Eye Hospital from July 2007 to July 2009. Baseline and monthly follow-up visits included best-corrected visual acuity (BCVA), fundus examination, and optical coherence tomography (OCT). Fluorescein and indocyanine green angiography (ICG) were performed at baseline and repeated at least every 6 months. RESULTS: We studied 5 eyes of 4 patients with a mean age of 66 years. Mean follow-up was 21 months (SD 1.9). The mean number of intravitreal injections administered for each patient was 10 (SD 4.6). The mean initial BCVA was 0.23 (decimal equivalent) (logMAR 0.64, SD 0.13). At the last follow-up, mean BCVA was 0.44 decimal equivalent (logMAR 0.36, SD 0.31). Mean central macular thickness (CMT) measured with OCT was 330 microm (SD 43) at baseline and decreased at the final follow-up to 243 microm (SD 44 ). Persistent intraretinal or subretinal fluid on OCT and/or multifocal areas of increased choroidal permeability on ICG angiographies were present in all patients at the last follow-up visit. CONCLUSIONS: Intravitreal ranibizumab appeared to be an effective treatment of CNV related to chronic CSC. However, residual intraretinal or subretinal fluid and increased choroidal permeability persisted. Prospective controlled studies are warranted to evaluate the long-term safety and efficacy of intravitreal ranibizumab.

Una visió de la Guerra de Successió des de l'exili: el 'Teatro de desdichas' (Milà, 1716)

El 1716 es publicà a Milà un text que fa una àmplia justificació històrica i política de la causa de Carles III d'Àustria a la Guerra de Successió d'Espanya (1702-1715). L'obra, de dimensions considerables (72 pàgines), va ser redactada per un eclesiàstic castellà que participà a la defensa de Barcelona durant el darrer setge i que va ser desterrat a Itàlia per les noves autoritats borbòniques. L'article analitza algunes de les idees centrals del text, com ara: l'oposició a la tirania borbònica i la defensa d'una monarquia moderada; la identificació de l'entronització de Felip V com el trencament de l'equilibri europeu i el punt culminant de la decadència d'Espanya; la denúncia de la traïció dels aliats; la vindicació de l'austriacisme castellà i la crítica al borbonisme d'alguns sectors catalans; i la descripció de la repressió i de l'exili.

A novel technique for the reconstruction of infected full-thickness chest wall defects.

BACKGROUND: Chest wall resection and reconstruction can be performed with minimal mortality and excellent functional and cosmetic results using synthetic meshes, methylmethacrylate, or other substitutes. However, these techniques are less easily applicable if chest wall resections have to be performed for infections. METHODS: We report a novel technique for this purpose using a modified latissimus dorsi flap harvested in continuity with the thoracolumbar fascia. The vascularized fascia was sutured into the chest wall defect, providing a stable base for the muscular component of the flap. Three patients requiring large full-thickness resections of the anterolateral chest wall for chronic infections were treated accordingly, two presenting with chronic radionecrosis and osteomyelitis and one with chest wall invasion by pulmonary aspergillosis. RESULTS: There were no intraoperative or postoperative complications and immediate extubation was possible in all 3 patients without the need for postoperative ventilation or tracheotomy. Healing of the infected chest wall was observed in all 3 patients. Postoperative cinemagnetic resonance imaging revealed concordant movements of the replaced segments without evidence of paradoxical motion during inspiration and expiration. CONCLUSIONS: This technique is easy and safe. It allows a stable and satisfactory reconstruction after large anterolateral full-thickness chest wall resections of infected, previously irradiated tissues, using only well-vascularized autologous tissue.

Comparison of human and rhesus macaque T-cell responses elicited by boosting with NYVAC encoding human immunodeficiency virus type 1 clade C immunogens.

Rhesus macaques (Macaca mulatta) have played a valuable role in the development of human immunodeficiency virus (HIV) vaccine candidates prior to human clinical trials. However, changes and/or improvements in immunogen quality in the good manufacturing practice (GMP) process or changes in adjuvants, schedule, route, dose, or readouts have compromised the direct comparison of T-cell responses between species. Here we report a comparative study in which T-cell responses from humans and macaques to HIV type 1 antigens (Gag, Pol, Nef, and Env) were induced by the same vaccine batches prepared under GMP and administered according to the same schedules in the absence and presence of priming. Priming with DNA (humans and macaques) or alphavirus (macaques) and boosting with NYVAC induced robust and broad antigen-specific responses, with highly similar Env-specific gamma interferon (IFN-gamma) enzyme-linked immunospot assay responses in rhesus monkeys and human volunteers. Persistent cytokine responses of antigen-specific CD4(+) and CD8(+) T cells of the central memory as well as the effector memory phenotype, capable of simultaneously eliciting multiple cytokines (IFN-gamma, interleukin 2, and tumor necrosis factor alpha), were induced. Responses were highly similar in humans and primates, confirming earlier data indicating that priming is essential for inducing robust NYVAC-boosted IFN-gamma T-cell responses. While significant similarities were observed in Env-specific responses in both species, differences were also observed with respect to responses to other HIV antigens. Future studies with other vaccines using identical lots, immunization schedules, and readouts will establish a broader data set of species similarities and differences with which increased confidence in predicting human responses may be achieved.

La fenomenología como posibilidad

Heidegger, en el parágrafo séptimo de Ser y Tienzpo, reconoció que el valor de la fenomenología reside en ser una posibilidad. Pues bien, se trata de indagar qué sentido pueda tener tal afirmación. Para ello, se analiza el sentido de los conceptos clave del planteamiento husserliano, teniendo encuenta toda su evolución y viendo cómo, de alguna manera, desde ellos quedan posibilitados la consideración y el estudio de ámbitos que, en cierta medida, significaban la ruptura del idealismo egológico y conciencialista, abriéndose a paradigmas filosóficos en los que se incluyen nuevas caracterizaciones de la subjetividad.

Figures des histoires de la Sainte Bible , avec des discours qui contiennent exactement ce qui est écrit de plus remarquable dans l'ancien et le nouveau Testament... Nouvelle édition, revüe & corrigée...

[Bible (français). 1724]

La dimensión instructiva de la orientación: El orientador como facilitador de los procesos de aprendizaje

Este artículo intenta poner al alcance de los profesionales españoles los últimos hallazgos de la corriente del consejo orientador aplicados a las casuísticas varias que presenta o puede presentar la intervención psicopedagógica en alumnos de cualquier nivel. En este caso concreto se hace mención sintética de las aportaciones de Jack Martín y su equipo, quienes convienen que un modelo de orientación o consejo instructivo es el ideal para su aplicación en las aulas. Este modelo tiene tres componentes (estructural, intencional y funcional) y se desarrolla bajo el marco de referencia de 1a. programación por objetivos. El artículo aplica el modelo a la orientación preventiva que habría que organizar en el caso de intentar prever las dificultades del aprendizaje (concretamente de los aprendizajes lingüísticos) para que el lector pueda comprender el funcionamiento y la utilización de tal paradigma. Las obras de J. Martín y de B. A. Hiebert son aún casi desconocidas en nuestro contexto, y pueden suponer un paso adelante en ámbitos orientadores que tengan la facilidad de trabajar en equipo.

Diagnosis of periprosthetic joint infections.

Advances in implant design, surgical technique, peri-operative antimicrobial prophylaxis and laminar airflow operating room environment have made total joint arthroplasty one of the most successful surgical procedures of all times. Orthopaedic implants, however, remain prone to microbial contamination resulting in persistent risk of implant-associated infection. Treatment of infections associated with orthopaedic devices usually requires appropriate surgical intervention combined with a prolonged antimicrobial therapy. The choice of the best possible treatment regimen depends on duration and pathogenesis of infection, stability of the implant, antimicrobial susceptibility of the pathogen and condition of the surrounding soft tissue. In addition towell known diagnostic procedures new promising tools for rapid and correct microbial diagnosis are being developed as correct diagnosis of the responsible micro-organism and this is paramount for successful treatment of prosthetic joint infection.

EV01: a phase I trial in healthy HIV negative volunteers to evaluate a clade C HIV vaccine, NYVAC-C undertaken by the EuroVacc Consortium.

NYVAC-C (vP2010), a recombinant vector expressing HIV subtype C gag, pol, env and nef antigens, was tested in a phase I study in healthy, HIV negative volunteers in London and Lausanne. Twenty-four participants were randomised to receive NYVAC-C (20) or matching placebo (4) at weeks 0 and 4, and assessed for safety and immunogenicity over 48 weeks. There were no serious adverse events, and no clinical or laboratory abnormalities or other events that led to withdrawal, interruption or dose reduction of the NYVAC-C/placebo. Half of the 10 assessed responded in the ELISpot assay under stringent criteria, which informed the sample size for a DNA-NYVAC-C comparison to NYVAC-C alone.

Models teòrics explicatius de l'aprenentatge motor

En este artículo se repasan los principales modelos teóricos explicativos del aprendizaje motor. En un primer apartado se comentan las aportaciones propias de la psicología cognitiva y más concretamente del corriente del procesamiento de la información: la Teoría del bucle cerrado de Jack Adams y la Teoría del esquema de Richard Schmidt. Posteriormente, se exponen las críticas que han recibido estos modelos y, para hacerlo, se introducen las principales aportaciones que el científico ruso Nikolai Bernstein hizo al estudio del aprendizaje y el control motor. A partir de estas aportaciones, se introducen las formulaciones teóricas que, surgidas desde la perspectiva dinámica-ecológica, pretenden superar las limitaciones de los modelos cognitivos. Finalmente, se comparan las dos perspectivas y se sugieren algunas posibles vías de desarrollo futuro del campo que nos ocupa.

Transcranial direct current stimulation for the treatment of focal hand dystonia.

The treatment of writer's cramp, a task-specific focal hand dystonia, needs new approaches. A deficiency of inhibition in the motor cortex might cause writer's cramp. Transcranial direct current stimulation modulates cortical excitability and may provide a therapeutic alternative. In this randomized, double-blind, sham-controlled study, we investigated the efficacy of cathodal stimulation of the contralateral motor cortex in 3 sessions in 1 week. Assessment over a 2-week period included clinical scales, subjective ratings, kinematic handwriting analysis, and neurophysiological evaluation. Twelve patients with unilateral dystonic writer's cramp were investigated; 6 received transcranial direct current and 6 sham stimulation. Cathodal transcranial direct current stimulation had no favorable effects on clinical scales and failed to restore normal handwriting kinematics and cortical inhibition. Subjective worsening remained unexplained, leading to premature study termination. Repeated sessions of cathodal transcranial direct current stimulation of the motor cortex yielded no favorable results supporting a therapeutic potential in writer's cramp.

Le fanatisme de l'ignorance confondu ou réponse à l'"Apologie des décrets" par le R. P. Lalande,... ([Reprod.]) / [par l'abbé Jabineau]

Collection : Les archives de la Révolution française ; 8.562

La légitimité du serment civique par M ***, convaincue d'erreur ([Reprod.]) / [Henri Jabineau]

Collection : Les archives de la Révolution française ; 8.591