Sirolimus-induced acneiform eruption.

Sirolimus is a new immunosuppressive agent used to prevent rejection in renal allograft recipients in order to reduce the need of potentially nephrotoxic calcineurin inhibitors (cyclosporine, tacrolimus). The cutaneous side effects of sirolimus are not well known and they may have been underestimated. We report 2 cases of follicular acneiform eruptions induced by sirolimus in renal allograft recipients. This dermatologic complication was severe and difficult to treat, and resolved only after discontinuation of sirolimus.

2009 Calendar Year Annual Report of the Watershed Improvement Review Board

The Board, codified in Chapter 466A, is an independent, self-governing body directed to award grants for water quality improvement and flood prevention in the state. The Board is authorized to request applications from soil and water conservation districts, local watershed improvement committees, public water supply utilities, counties, county conservation boards and cities and award grants to these entities. These grants are issued from the Watershed Improvement Fund. Annual appropriations of $5 million plus interest earned on the Watershed Improvement Fund allowed the Board to issue two Request For Applications in 2009. On February 27, the Board awarded grants to seven applicants for a total of $2,366,861. On September 21, the Board awarded grants to thirteen applicants for a total of $5,120,832. In addition to providing environmental benefits, these implementation projects stimulate economic recovery and create jobs through the purchasing oflocal goods and services.

Meta-análise do uso de ácido linoleico conjugado na alimentação de suínos

O objetivo deste trabalho foi realizar uma meta-análise da associação do ácido linoleico conjugado (CLA) com o desempenho e a qualidade de carcaça e de carne em suínos (Sus scrofa domesticus). A base de dados utilizada contemplou 15 artigos publicados entre 1999 e 2006, e totalizou 216 dietas e 5.223 animais. A meta-análise foi realizada por meio de análises gráficas (para observar coerência biológica dos dados), de correlação (para identificar variáveis correlacionadas) e de variância-covariância. O modelo da análise de variância incluiu apenas as variáveis de carne e carcaça mais correlacionadas com o consumo de CLA pelos animais, além das codificações para os efeitos inter e intra-experimentos. A inclusão do ácido linoleico apresentou correlação negativa com a eficiência alimentar e positiva com o consumo de ração e o ganho de peso dos animais. Não houve alteração do consumo de ração, do ganho de peso e da eficiência alimentar dos suínos. O ácido linoleico conjugado aumentou em 9% o conteúdo de carne magra na carcaça, e seu consumo variou a espessura média de toucinho. O ácido linoleico conjugado aumenta o conteúdo de carne magra e reduz a espessura de toucinho na carcaça, sem influenciar o desempenho e a qualidade da carne em suínos.

Predictive accuracy of original and recalibrated Framingham risk score in the Swiss population.

OBJECTIVE: To compare the predictive accuracy of the original and recalibrated Framingham risk function on current morbidity from coronary heart disease (CHD) and mortality data from the Swiss population. METHODS: Data from the CoLaus study, a cross-sectional, population-based study conducted between 2003 and 2006 on 5,773 participants aged 35-74 without CHD were used to recalibrate the Framingham risk function. The predicted number of events from each risk function were compared with those issued from local MONICA incidence rates and official mortality data from Switzerland. RESULTS: With the original risk function, 57.3%, 21.2%, 16.4% and 5.1% of men and 94.9%, 3.8%, 1.2% and 0.1% of women were at very low (<6%), low (6-10%), intermediate (10-20%) and high (>20%) risk, respectively. With the recalibrated risk function, the corresponding values were 84.7%, 10.3%, 4.3% and 0.6% in men and 99.5%, 0.4%, 0.0% and 0.1% in women, respectively. The number of CHD events over 10 years predicted by the original Framingham risk function was 2-3 fold higher than predicted by mortality+case fatality or by MONICA incidence rates (men: 191 vs. 92 and 51 events, respectively). The recalibrated risk function provided more reasonable estimates, albeit slightly overestimated (92 events, 5-95th percentile: 26-223 events); sensitivity analyses showed that the magnitude of the overestimation was between 0.4 and 2.2 in men, and 0.7 and 3.3 in women. CONCLUSION: The recalibrated Framingham risk function provides a reasonable alternative to assess CHD risk in men, but not in women.

Pontificale parisiense [Pontifical dit de Poitiers ou de Vierzon].

Sur le feuillet de garde A, cette note autographe de Mabillon : « Hic codex optimae notae scriptus est ante annos circiter octingentos. Multa scitu digna continet, maxime in triduo ante Pascha. In litaniis sabbati sancti fit supplicatio pro congregatione S. Petri, quem patronum habet Pictavensis ecclesia. Invocantur etiam in iisdem sanctus Hilarius et sancta Radegundis, qui praecipue ad ecclesiam Pictavensem pertinent ; sed nulla mentio de aliis sanctis ejusdem dioecesis. Haec scripsi XI kal. decembris an. 1695. — F. J. M. » Fol. 1 : « Benedictio episcoporum. — Consecratio ». Fol. 2 : « Oratio ad ordinandum praesbiterum. — Consecratio. ». Fol. 3 : « Oratio ad ordinandum diaconum. — Consecratio. » Fol. 4 : « Ordo qualiter in Romana ecclesia praesbiteri, diaconi, subdiaconi ordinandi sunt. » Fol. 5 : « Ordinatio subdiaconi ». Fol. 5v° : « Ordinatio ostiarii. » Fol. 6 : « Ordinatio lectoris ». Fol. 6v° : « Ordinatio exorcistae ». Fol. 7 : « Ordinatio acoliti ». Fol. 7v° : « Incipit ordo qualiter publice vel specialiter agitur modus paenitentiae secundum censuram ecclesiasticam, quod quarta feria quinquagesime inchoatur ». Fol. 8v° : « Confessio pura coram Deo et angelis et coram omnibus sanctis » : — de superbia (fol. 12) ; de inani gloria (fol. 13) ; de invidia (fol. 13 vo) ; de ira (fol. 14 vo) ; de tristitia (fol. 15) ; de avaricia (fol. 16) ; de ventris ingluvie (fol. 20) ; de luxuria (fol. 23). Fol. 40v° : « Missa pro paenitentibus et confitentibus, sive unus sive plures fuerint ». Fol. 43 : « Denunciatio scrutinii quod tertia ebdomada in quadragesima secunda feria iniciatur ». Fol. 43v° : « Oratio super electos ad catecuminum faciendum ». Fol. 44 : « Benedictio salis dandi caticuminis. » — Prières et exhortations aux catéchumènes. Explication des évangiles. Fol. 54-56 : Le Credo, en grec avec traduction latine au-dessus. La traduction est faite de mot à mot. Pour l'article grec, le traducteur s'est contenté de mettre au-dessus, dans le texte latin, ces lettres ar. (articulus). Fol. 58v° : Explication du Pater. Fol. 60v° : « Incipit missa primi scrutinii ». Fol. : 63 : « Alia missa de secundo scrutinio ». Fol. 66v° : « Missa de tertio scrutinio ». Fol. 70 : « Sabbato ante diem Palmarum ». Fol. 72 : « Dominica indulgentiae quae est dies Palmarum ». Fol. 73 : Les 36 premiers vers de la pièce Gloria, laus de Théodulfe, évêque d'Orléans (Henry Martin signale l'éd. qu'en a fait Duemmler dans les Poetae latini aevi carolini, t. I, p. 558 : « Gloria, laus et honor tibi sit, Christe redemptor, Cui puerile decus promsit osanna pium. Israhel es tu rex Davidis et inclita proles, Nomine qui in Domini, rex benedicte, venis... » Fol. 95 :« Feria II post Palmas ». Fol. 98v° : « Feria tertia ». Fol. 130 : « Feria V, quae est cena Domini ». Fol. 141v° : « Alia missa eodem die, si plures ad reconciliandum venerint ». Fol. 154 : « Missa chrismalis ». Fol. 160 : Litanies. A noter : SS. Denys, Quentin, Julien, Géréon, Hilaire, Martin, Aignan, Benoît, Cloud [Clodoald], Ste Geneviève. Fol. 170v° : « Benedictio chrismatis principalis ». Fol. 171 : « Exorcismus olei ad baptizandos ». Fol. 173v° : In cena Domini de Flavius, évêque: « Versus Flavii episcopi ad mandatum in cena Domini ». « Tellus a cethra jubilent in magni cena principis, Que protoplasti pectora vite purgavit ferculo ; Hac nocte factor omnium potenti sat mysterio Carnem suam cum sanguine in escam transfert anime. — Tellus. » Fol. 174 : « Item versus Bedae » (Bède). « Fuit Domini dilectus languens a Bethania Lazarus beatus sacris olim cum sororibus quas Jhesus eternus Amor diligebat plurimum Martham simul et Mariam, felices per secula. » Fol. 174v° : « Feria VI quae est Parasceve ». Fol. 192v° : « Pange lingua gloriosi Proelium certaminis ». Fol. 193 : « Incipit de sabbato sancto. — Ordo baptisterii ». Fol. 200v° : Litanies. A noter : SS. Quentin, Cucuphat, Julien, Lucien, Hilaire, Martin, Benoît, Germain, Columban, Samson ; SStes Geneviève, Brigitte, Colombe, Radegonde, Aldegonde. — A noter aussi (fol. 201 vo) : « Ut exercitum Francorum conservare digneris. — Ut illum abbatem et cunctam congregationem sancti illius in tuo apto servitio conservare digneris... » Fol. 202 : « Benedictio cerei. — Exultet jam angelica turba coelorum. Exultent divina mysteria... », avec neumes. Fol. 208 : Litanies. A noter : SS. Hilaire, Martin, Ambroise, Maur, Maurille, Lezin, évêque d'Angers ; SStes Blandine, Nathalie. Fol. 210 : « Inde canitur hic versus : »« Urbs beata Hierusalem, dicta pacis visio, que construitur in celis vivis ex lapidibus... » Fol. 210v° : « Benedictio fontis ». Fol. 213 : vers « Tibi laus perennis auctor baptismatis... » Fol. 213v° : Litanies. A noter : SS. Martin, Brice, Médard, Vaast, Germain, Marcel, Hilaire ; SStes Reine, Julienne, Gertrude, Colombe, Geneviève, Afre, Radegonde, Aldegonde, Darie, Brigitte, Paule. — A noter (fol. 215) : « Ut exercitum Francorum conservare digneris. — Ut congregationem sancti Petri in tuo apto servitio conservare digneris ». Fol. 223 : « Finit ordo baptisterii ». Fol. 227 : Le jour de Pâques. Fol. 230v° : « Feria II ». Fol. 241 : « Feria quinta ». Fol. 245v° : « Feria VI ». Fol. 248 : « Sabbato ». Fol. 252v° : « In octavis Paschae ». Fol. 256v° : « Missa in octavis Paschae pro baptizatis ». Fol. 257v° : « Missa pro parroechias in diebus paschalibus... ». Fol. 258v° : « Fides catholica continens credulitatem... » Fol. 269 : « Missa pro conjugibus sterilitate infecundis in procreatione prolis ». Fol. 273v° : « Orationes ad benedicendam aquam aspergendam in domo. — Exorcismus salis ». Fol. 274 : « Benedictio salis. — Exorcismus aque. — Benedictio aque ». Fol. 274v° : « Benedictio salis et aquae... » etc. Fol. 275 : « Exorcismus salis et aquae contra fulgura ». Fol. 276 : « Benedictio salis ad pecora. — Orationes ad clericum faciendum ». Fol. 276v° : « Benedictio putei ». Fol. 277 : « Benedictio frugum novarum ». Fol. 277v° : « Benedictio panis. — Oratio ad capillarum (sic). — Alia ad tonsorandum puerum ». Fol. 278 : « Oratio post tonsionem. — Oratio ad barbas tondendas ». Fol. 278 : « lncipit actio pontificalis ad... » . Le verso du feuillet 279 est tout à fait effacé. Neumes français, du IXe s., aux f. 202-204 (l'Exultet) ; addition du Xe s. au f. 203 v° (Bernard).

ESPEN Guidelines on Enteral Nutrition: Intensive care.

Enteral nutrition (EN) via tube feeding is, today, the preferred way of feeding the critically ill patient and an important means of counteracting for the catabolic state induced by severe diseases. These guidelines are intended to give evidence-based recommendations for the use of EN in patients who have a complicated course during their ICU stay, focusing particularly on those who develop a severe inflammatory response, i.e. patients who have failure of at least one organ during their ICU stay. These guidelines were developed by an interdisciplinary expert group in accordance with officially accepted standards and are based on all relevant publications since 1985. They were discussed and accepted in a consensus conference. EN should be given to all ICU patients who are not expected to be taking a full oral diet within three days. It should have begun during the first 24h using a standard high-protein formula. During the acute and initial phases of critical illness an exogenous energy supply in excess of 20-25 kcal/kg BW/day should be avoided, whereas, during recovery, the aim should be to provide values of 25-30 total kcal/kg BW/day. Supplementary parenteral nutrition remains a reserve tool and should be given only to those patients who do not reach their target nutrient intake on EN alone. There is no general indication for immune-modulating formulae in patients with severe illness or sepsis and an APACHE II Score >15. Glutamine should be supplemented in patients suffering from burns or trauma.

Obispos y gladiadores: El recurso a los profesionales del anfiteatro en disputas por la elección episcopal.

[spa]La costumbre de enrolar a combatientes del anfiteatro (arenarii) como guardia personal en el marco de luchas faccionales sobrevivió durante el siglo IV. Incluso si en la mayor parte de casos este fenómeno se explica por razones políticas, conocemos dos ejemplos en los que los candidatos a obispo recurrieron a gladiadores para triunfar sobre sus oponentes. El primer ejemplo está relacionado con la elección de Silvano (en el 305 o en el 307/308), quien llegó a hacerse elegir obispo de Cirta (actual Constantine)gracias a la ayuda del arenarius Muto. Esta ayuda quedó bien demostrada por el testimonio de diversas personas durante el proceso seguido contra Silvano en el 320, en el que se reconoció su culpabilidad y se le condenó al exilio. El segundo ejemplo es el del papa Dámaso (366), elegido obispo de Roma en la iglesia de Lucina el mismo día en el que el diácono Ursino era escogido en la basílica de Julio. En el conflicto siguiente, Dámaso convocó a arenarii, quadrigari y fossores, quienes acudieron en su ayuda fuertemente armados. Éstos atacaron la basílica en la que se habían refugiado los partidarios de Ursino y el resultado del asalto fue de 137 muertos. [eng]The habit of engaging fighters of the amphitheatre (arenarii) as a personal guard in the factional struggles survived during the 4th century. Although in most cases it was about political causes, we know two examples where the candidates to be bishops turned to gladiators in order to overcome their opponents. The first example is that of election of Silvanus (305 or 307-308), who got the bishopric of Cirta (the modern Constantine) thanks to the help of the arenarius Mutus. This help was proved by the testimony of several witnesses during the trial which was followed against Silvanus in 320, where his guilt was admitted and he was condemned to the exile. The second exemple is that of the the Pope Damasus (366), elected bishop of Rome in the church of Lucina in the same day as the deacon Ursinus was elected in the basilica of Julius. In the conflict that was to follow, Damasus called arenarii, quadrigarii and fossores who came to help him heavily armed. They attacked the basilica where the supporters of Ursinus had taken refuge and as a result of the assault 137 people died.

Genetic analysis of sudden cardiac death victims: a survey of current forensic autopsy practices.

Autopsy-negative sudden cardiac deaths (SCD) seen in forensic practice are most often thought to be the result of sudden arrhythmic death syndrome. Postmortem genetic analysis is recommended in such cases, but is currently performed in only a few academic centers. In order to determine actual current practice, an on-line questionnaire was sent by e-mail to members of various forensic medical associations. The questions addressed routine procedures employed in cases of sudden cardiac death (autopsy ordering, macroscopic and microscopic cardiac examination, conduction tissue examination, immunohistochemistry and electron microscopy, biochemical markers, sampling and storage of material for genetic analyses, toxicological analyses, and molecular autopsy). Some questions concerned the legal and ethical aspects of genetic analyses in postmortem examinations, as well as any existing multidisciplinary collaborations in SCD cases. There were 97 respondents, mostly from European countries. Genetic testing in cases of sudden cardiac death is rarely practiced in routine forensic investigation. Approximately 60% of respondents reported not having the means to perform genetic postmortem testing and 40% do not collect adequate material to perform these investigations at a later date, despite working at university hospitals. The survey demonstrated that many of the problems involved in the adequate investigation of SCD cases are often financial in origin, due to the fact that activities in forensic medicine are often paid by and dependent on the judicial authorities. Problems also exist concerning the contact with family members and/or the family doctor, as well as the often-nonexistent collaboration with others clinicians with special expertise beneficial in the investigation of SCD cases, such as cardiologists and geneticists. This study highlights the importance in establishing guidelines for molecular autopsies in forensic medicine.

Les divers sens de la notion d'autonomie en médecine et leur pertinence en clinique [The various senses of autonomy and their relevance to clinical practice]

Since the introduction of the principle of respect of autonomy in medical ethics, the respect of the will of the patient occupied a central place in the decision-making process. To face up to the difficulties that appeared during the application of this principle in clinical medicine, Bruce Miller proposed in the early eighties one way to clarify the significance of this notion in the field of medical practice. He showed that the concept of autonomy can be understood under four senses which deserve to be explored in case of ethical conflict. This article shows, through the analysis of a clinical situation, the relevance of the approach suggested by this author and proposes to refer to this approach in case of ethical dilemmas in clinical practice.

The JNK inhibitor XG-102 protects from ischemic damage with delayed intravenous administration also in the presence of recombinant tissue plasminogen activator.

BACKGROUND: XG-102 (formerly D-JNKI1), a TAT-coupled dextrogyre peptide which selectively inhibits the c-Jun N-terminal kinase, is a powerful neuroprotectant in mouse models of middle cerebral artery occlusion (MCAo) with delayed intracerebroventricular injection. We aimed to determine whether this neuroprotection could also be achieved by intravenous injection of XG-102, which is a more feasible approach for future use in stroke patients. We also tested the compatibility of the compound with recombinant tissue plasminogen activator (rtPA), commonly used for intravenous thrombolysis and known to enhance excitotoxicity. METHODS: Male ICR-CD1 mice were subjected to a 30-min-suture MCAo. XG-102 was injected intravenously in a single dose, 6 h after ischemia. Hippocampal slice cultures were subjected to oxygen (5%) and glucose (1 mM) deprivation for 30 min. rtPA was added after ischemia and before XG-102 administration, both in vitro and in vivo. RESULTS: The lowest intravenous dose achieving neuroprotection was 0.0003 mg/kg, which reduced the infarct volume after 48 h from 62 +/- 19 mm(3) (n = 18) for the vehicle-treated group to 18 +/- 9 mm(3) (n = 5, p &lt; 0.01). The behavioral outcome was also significantly improved at two doses. Addition of rtPA after ischemia enhanced the ischemic damage both in vitro and in vivo, but XG-102 was still able to induce a significant neuroprotection. CONCLUSIONS: A single intravenous administration of XG-102 several hours after ischemia induces a powerful neuroprotection. XG-102 protects from ischemic damage in the presence of rtPA. The feasibility of systemic administration of this promising compound and its compatibility with rtPA are important steps for its development as a drug candidate in ischemic stroke.

Iowa Department of Transportation Major Items - Preliminary Quantity Report, June 21, 2016; With Addendums

Weekly letting report

Interrogating eleven fast-evolving genes for signatures of recent positive selection in worldwide human populations

Different signatures of natural selection persist over varying time scales in our genome, revealing possible episodes of adaptative evolution during human history. Here, we identify genes showing signatures of ancestral positive selection in the human lineage and investigate whether some of those genes have been evolving adaptatively in extant human populations. Specifically, we compared more than 11,000 human genes with their orthologs inchimpanzee, mouse, rat and dog and applied a branch-site likelihood method to test for positive selection on the human lineage. Among the significant cases, a robust set of 11 genes were then further explored for signatures of recent positive selection using SNP data. We genotyped 223 SNPs in 39 worldwide populations from the HGDP Diversity panel and supplemented this information with available genotypes for up to 4,814 SNPs distributed along 2 Mb centered on each gene. After exploring the allele frequency spectrum, population differentiation and the maintainance of long unbroken haplotypes, we found signals of recent adaptative phenomena in only one of the 11 candidate gene regions. However, the signal ofrecent selection in this region may come from a different, neighbouring gene (CD5) ratherthan from the candidate gene itself (VPS37C). For this set of positively-selected genes in thehuman lineage, we find no indication that these genes maintained their rapid evolutionarypace among human populations. Based on these data, it therefore appears that adaptation forhuman-specific and for population-specific traits may have involved different genes.