Reliure de : Il magno palazzo del cardinale di Trento, poema in ottava rima di Andrea Matthioli

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Clinical usefulness of therapeutic concentration monitoring for imatinib dosage individualization: Results from the randomized controlled I-COME Trial

Introduction: Imatinib trough plasma concentrations (Cmin) have been correlated with treatment response in chronic myeloid leukemia (CML) patients. The use of Cmin monitoring for optimizing imatinib dosage (therapeutic drug monitoring [TDM]) is therefore proposed for patients with unsatisfying response or tolerance ("rescue TDM"). A cycle of "routine TDM" for dosage individualization could also be beneficial to prevent unfavorable events, yet its clinical usefulness has not been evaluated. We aimed to assess prospectively whether a "routine TDM" intervention targeting imatinib Cmin of 1000 ng/mL (tolerance, 750-1500 ng/mL) could improve efficacy, tolerance, and persistence on treatment compared with "rescue TDM" use only. Patients (or Materials) and Methods: The Swiss Imatinib COncentration Monitoring Evaluation (I-COME) study was a multicenter randomized controlled trial (ISRCTN31181395). Adult patients in chronic or accelerated phase CML receiving imatinib ≤5 years were eligible. Patients were randomly (1:1) allocated to receive "routine TDM" intervention or to serve as controls with access only to "rescue TDM". All had 1-year follow-up. The primary endpoint was a combined efficacy-safety outcome (failure- and toxicity-free survival without imatinib discontinuation), analyzed in intention-to-treat. Results: Among 56 CML recruited patients, 55 had their molecular and cytogenetic response measured. 14/27 of patients receiving "routine TDM" (52% [33%-71%]) remained event-free versus 16/28 of control patients with "rescue TDM" only (57% [39%-75%]; P=0.69). In the "routine TDM" group, dosage recommendations were adopted entirely in 50% of patients (median Cmin at study end, 895 ng/mL; CV = 33%). These patients had fewer unfavorable events (28% [5%-52%]) compared with patients not receiving the advised dosage (77% [54%-99%]; P = 0.03; median Cmin at study end, 648 ng/mL; CV = 38%). Conclusion: This first prospective target concentration intervention trial could not formally demonstrate a benefit of "routine TDM" of imatinib, especially due to a small patient number and limited prescriber's adherence to dosage recommendations. Nevertheless, the patients receiving the advised dosage more often met target concentrations and the combined outcome (efficacy, tolerance, and persistence). A cycle of routine TDM could thus be favorable, at least in patients eligible for dosage adjustment. Its usefulness should, however, be further confirmed in larger trials.

Oikeuden "ikuiset totuudet" : kommentti Kaarlo Tuorille

Oikeustieteen päivät 20.-21.12.1996

Reliure de : Discorso di M. Sebastiano Erizzo sopra le medaglie antiche...

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[Illustration de Le Voyage de Monsieur Lautrec] / [Non identifié] ; J. de Forges, aut. du texte

Comprend : [Page de titre avec figures. Scènes de sièges de villes fortifiées et de combats. Mendiant recevant l'aumône] [Cote : BNF C56281]

Reliure de : I Discorsi di M. Pietro Andrea Matthioli,... nelli sei libri di Pedacio Dioscoride,... della materia medicinale, hora di nuovo dal suo istesso autore ricorretti et... aumentati... con due tavole copiosissime... - Del Modo di distillare le acque da tutte le piante, et come vi si possino conservare i loro veri odori et sapori

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[Illustrations de Les Commentaires de Jules César.] / [non identifié] ; Jules César, aut. du texte

Comprend : [pl. à la Dédicace : scène de dédicace. Robert, ministre de l'ordre de la Sainte Trinité, remet au roi de France Charles VIII les "Commentaires de Jules César".] [Cote : microfilm m 7991/R 93674] ; [Fig. en reg. folio aiiii : Jules César et son armée.] Cy apres sensuyt le premier livre des commentaires de Jules Cesar sur le fait de la conqueste de la terre de Gaule laquelle il fist avant quil se nommast empereur de romme. [Cote : microfilm m ; [Fig. au Second Livre : combat entre soldats romains et gaulois.] Cy commence le deuxiesme livre des cômentairesiules cesar. [Cote : microfilm m 7991/R 93674] ; [Fig. au Troisième Livre : soldat romain décapitant un Savoyard.] Cy commence le troisiesme livre. [Cote : microfilm m 7991/R 93674] ; [Fig. au Quatrième Livre : bataille entre l'armée de Jules César et des soldats Germains.] Sensuit le quatriesme livre. [Cote : microfilm m 7991/R 93674] ; [Fig. au Cinquième Livre : Jules César ordonne la construction de navires de guerre.] Cy commence le cinquiesme livre. [Cote : microfilm m 7991/R 93674] ; [Fig. au Sixième Livre : Jules César ordonne la construction de navires de guerre?] Cy commence le sixiesme livre. [Cote : microfilm m 7991/R 93674] ; [Fig. au Septième Livre : Jules César rassemble son armée devant Rome.] Cy commence le septiesme livre. [Cote : microfilm m 7991/R 93674] ; [Fig. au Huitième Livre : Jules César et son armée.] Cy commence le huitiesme livre fait par ung nomme Bircius pensa. [Cote : microfilm m 7991/R 93674]

Water retention in a peatland with organic matter in different decomposition stages

Peatlands are ecosystems formed by successive pedogenetic processes, resulting in progressive accumulation of plant remains in the soil column under conditions that inhibit the activity of most microbial decomposers. In Diamantina, state of Minas Gerais, Brazil, a peatland is located at 1366 m asl, in a region with a quartz-rich lithology and characteristic wet grassland vegetation. For this study, the peat area was divided in 12 transects, from which a total of 90 soil samples were collected at a distance of 20 m from each other. The properties rubbed fiber content (RF), bulk density (Bd), mineral material (MM), organic matter (OM), moisture (Moi) and maximum water holding capacity (MWHC) were analyzed in all samples. From three selected profiles of this whole area, samples were collected every 27 cm from the soil surface down to a depth of 216 cm. In these samples, moisture was additionally determined at a pressure of 10 kPa (Moi10) or 1500 kPa (Moi1500), using Richards' extractor and soil organic matter was fractionated by standard procedures. The OM decomposition stage of this peat was found to increase with soil depth. Moi and MWHC were highest in layers with less advanced stages of OM decomposition. The humin levels were highest in layers in earlier stages of OM decomposition and with higher levels of water retention at MWHC and Moi10. Humic acid contents were higher in layers at an intermediate stage of decomposition of organic matter and with lowest levels of water retention at MWHC, Moi10 and Moi1500.

Postoperative Cognitive Dysfunction (POCD) and Inflammatory Markers in Elderly Patients

Introduction: Particularly in elderly patients, the brain responds to a systemic inflammatory response with an increased production of inflammatory mediators. This has hypothetically been linked to the development of postoperative cognitive dysfunction (POCD). Methods: We investigated 31 patients aged >65 yrs undergoing elective major surgery under standardized general anaesthesia (thiopental, sevoflurane, fentanyl, atracurium). Cognitive function was measured preoperatively and 7 days postoperatively using the extended version of the Consortium to Establish a Registry for Alzheimer's Disease - Neuropsychological Assessment Battery (CERAD-NAB, validated German version) for which we developed a diagnostic cut-off in healthy elderly volunteers. Systemic C-reactive protein (CRP) and interleukin 6 (IL-6) were measured preoperatively, 2 days postoperatively, and 7 days postoperatively. Values for CRP, IL-6, operative characteristics and hospital length of stay in patients with POCD and without POCD were compared using the Mann- Whitney U test and are shown as median [range]. Results: Fourteen patients (45%) developed POCD. Values for CRP were not statistically different in patients with POCD and without POCD but tended to be higher in patients with POCD 2 days postoperatively. Patients with POCD had significantly higher IL-6 values on postoperative days 2 and 7 (table 1). These patients also had a significantly longer duration of anaesthesia (305 [195-620] vs.190 [150-560] min, p = 0.034), larger intraoperative blood loss (425 [0-1600] vs. 100 [0-1500] ml, p = 0.018) and longer hospital stays (15 [8-45] vs. 8 [4-40] days, p = 0.008). Table 1 POCD (n = 14) No POCD (n = 17) p value CRP (mg/dl) preop. 4.0 [1.0-245] 4.2 [0.3-36.2] 0.6 2 days postop. 223 [20-318] 98 [4.5-384] 0.07 7 days postop. 58 [15-147] 44 [11-148] 0.2 IL-6 (U/ml) preop. 2[2-28.1] 2 [2-7.3] 0.8 2 days postop. 56 [17-315] 20 [2-123] 0.009 7 days postop. 9[2-77] 4 [2-16] 0.03 Interpretation: In this small group of patients, high IL-6 values postoperatively were associated with POCD supporting a role for systemic inflammation in the development of POCD. In patients with POCD, duration of anaesthesia was significantly longer, and intraoperative blood losses were larger. These risk factors will need to be confirmed in a larger group of patients. The difference in length of stay may be indicative of postoperative complications, which have been linked to POCD earlier.

Curva de retenção de água no solo pelo método do papel-filtro

O método mais tradicional para determinação da curva de retenção de água no solo emprega a câmara de pressão de Richards. Por questões práticas, a busca por métodos alternativos ao de Richards, financeiramente mais acessíveis e menos morosos, faz-se interessante. Diante disso, desenvolveu-se o presente trabalho com o objetivo de avaliar o uso do método do papel-filtro. Para isso, realizou-se inicialmente coleta, caracterização física e preparo de amostras indeformadas de um Latossolo Vermelho distroférrico típico e ensaio em câmara de Richards, utilizando pressões de 0, 10, 30, 60, 100, 300, 500, 1000 e 1500 kPa. No ensaio com o papel-filtro, mediu-se o potencial matricial da água em amostras cujas umidades foram previamente estabelecidas, utilizando-se curva de calibração adequada. Os ensaios resultaram em pontos de pressão versus umidade, que foram ajustados pelo modelo de van Genuchten, utilizando o programa RETC. Realizou-se uma análise comparativa de valores de umidade volumétrica estimados pelo modelo ajustado nos ensaios com o papel-filtro com a curva de retenção ajustada obtida pela câmara de Richards. Por meio dessa comparação, verificou-se a aplicabilidade do método do papel-filtro para determinação da curva de retenção de água no solo agrícola utilizado.

Nitrate role in basic cation leaching under no-till

Especially under no-tillage, subsuface soil acidity has been a problem, because it depends on base leaching, which has been associated with the presence of low molecular weigth organic acids and companion anions. The objective of this study was to evaluate exchangeable base cation leaching as affected by surface liming along with annual urea side-dressing of maize and upland rice. Treatments consisted of four lime rates (0, 1500, 3000, and 6000 kg ha-1) combined with four nitrogen rates (0, 50, 100, and 150 kg ha-1) applied to maize (Zea mays) and upland rice (Oryza sativa), in two consecutive years. Maize was planted in December, three months after liming. In September of the following year, pearl millet (Pennisetum glaucum) was planted without fertilization and desiccated 86 days after plant emergence. Afterwards, upland rice was grown. Immediately after upland rice harvest, 18 months after surface liming, pH and N-NO3-, N-NH4+, K, Ca, and Mg levels were evaluated in soil samples taken from the layers 0-5, 5-10, 10-20 and 20-40 cm. Higher maize yields were obtained at higher N rates and 3000 kg ha-1 lime. Better results for upland rice and pearl millet yields were also obtained with this lime rate, irrespective of N levels. The vertical mobility of K, Ca and Mg was higher in the soil profiles with N fertilization. Surface liming increased pH in the upper soil layers causing intense nitrate production, which was leached along with the base cations.

Audit report on Indian Hills Community College in Ottumwa, Iowa for the year ended June 30, 2011

Audit report on Indian Hills Community College in Ottumwa, Iowa for the year ended June 30, 2011