[8 phot. de l'inlandsis du Groenland par J. Jaeger, phot. à Stockholm, d'après des dessins du docteur Berggren, juillet 1870, don A. E. Nordenskild]

Donateur : Nordenskjöld, Adolf Erik (1832-1901)

Sceaux détachés (originaux en cire), cachets, armoiries, jetons et médailles, dessinés ou gravés. XI 356 numéros (ex-libris armoriés, sceaux dessinés ou gravés, cachets, armoiries, dessins de jetons et médailles, etc.).

Contient : N° 53 Sceau de Catherine d'Alençon, duchesse de Bavière (1416) ; Nos 56 et 57 Sceaux de Jean, duc de Calabre et de Lorraine (31 octobre 1465) et de son fils aîné ; N° 58 Sceau de Marguerite, reine d'Angleterre (1470) ; N° 59 Sceau de Bernardin Bochetel, évêque de Rennes (1564) ; N° 61 « S. Petri, Dei gratia archiepiscopi Tholosani » [Pierre V de Lion ?] ; Nos 62 et 64 Sceau de Robert d'Alençon, comte du Perche (1370 et 1375) ; Nos 72 et 81 Médailles du roi René (dessins) ; N° 73 Sceau de Jeanne, reine de Jérusalem, Sicile et Aragon (1498), avec contre-sceau ; N° 74 Sceau et contre-sceau de Louis de France, duc d'Anjou et roi de Sicile ; N° 75 Sceau d'Isabelle, comtesse du Maine et de Guise (1462), avec contresceau ; N° 76 Sceau et contre-sceau de René d'Anjou, roi de Sicile et de Jérusalem ; N° 77 « [S. Nicolai] ducis Calabrie, Lotharingie, A[ndegavie]..., » avec contre-sceau ; N° 78 Sceau de Pierre, comte d'Alençon, seigneur de Fougères, vicomte de Beaumont (1378), avec contre-sceau ; Nos 79 et 82 Sceau et contre-sceau de Louis II, roi de Jérusalem et de Sicile et comte d'Anjou (1407 et 1408) ; Nos 80 et 88 Sceau et contre-sceau de Robert, comte d'Artois ; N° 84 « S. novum Ludovici, regis Fran. filii, ducis Andegavensis et comitis Cenomannensis, » avec contre-sceau (1374) ; N° 85 Sceau et contre-sceau de Catherine, fille aînée du duc d'Alençon, « comtesse de Montfort, dame de Sonois » ; N° 86 Sceau et contre-sceau de Charles, comte du Maine (1451) ; N° 87 « Scel René d'Anjou, chlr., baron et s. de Mézières et de Thury, » avec contre-sceau ; N° 89 Sceau de Yolande reine de Jérusalem et de Sicile (1428) ; N° 94 Sceau d'Henri de Carinthie, évêque de Troyes ; cf. vol. 3101, n° 8 ; N° 101 Sceau de Charles, comte d'Alençon (1361) ; N° 112 Sceau d'Antoine de Cravant, abbé de la Trinité de Vendôme ; cf. vol. 3113, n° 7 ; N° 113 « Sigillum Johannis, episcopi Silvanectensis » [Jean Neveu † 1499, ou Jean Calveau † 1522] ; N° 115 Sceau de Jean de Tinteniac du Percher, abbé de Saint-Aubin († 1525) ; N° 120 « Scel Pierre, bastart d'Alençon » (1419) ; N° 128 « Constras. Ludovici, regis condam Francor. filii, ducis Andegavie et comit. Cenamanie. » ; N° 154 Sceau de Mathieu, évêque de Troyes (1169-1180) ; N° 257 Sceau de René, duc d'Alençon (1478)

Missale ad usum ecclesiae Aquensis.

F. 1-6v Calendrier de l'église d'Aix-en-Provence (7 juin: « Sancti Maximini Aquensis archiepiscopi... »; 7 août: « Dedicatio ecclesie Sancti Salvatoris »). F. 7-282 Temporal de toute l'année. F. 282v-286v Préfaces. F. 287-290v Canon de la messe. F. 291v-292 Peintures du Canon. F. 293-425 Sanctoral et commun des saints (f. 332v: s. Maximin; f. 352v: ste Marie-Madeleine; f. 361: dédicace de l'église; f. 374: s. Agricol; f. 393: s. Mitre). F. 425-431 « Orationes processionales per totum annum ». F. 431v-432v Bénédictions. F. 432v-433v Bénédictions et préface du mariage. F. 434-435 Messes de divers saints (dont s. Cannat, évêque de Marseille). F. 435v Colophon.

Outpatient prescription writing quality in a paediatric general hospital

Introduction The writing of prescriptions is an important aspect of medical practice. Since 2006, the Swiss authorities have decided to impose incentives to prescribe generic drugs. The objectives of this study were 1) to determine the evolution of the outpatient prescription practice in our paediatric university hospital during 2 periods separated by 5 years; 2) to assess the writing quality of outpatient prescriptions during the same period.Materials & Methods Design: Copies of prescriptions written by physicians were collected twice from community pharmacies in the region of our hospital for a 2-month period in 2005 and 2010. They were analysed according to standard criteria regarding both formal and pharmaceutical aspects. Drug prescriptions were classified as a) complete when all criteria for safety were fulfilled, b) ambiguous when there was a danger of a dispensing error because of one or more missing criteria, or c) containing an error.Setting: Paediatric university hospital.Main outcome measures: Proportion of generic drugs; outpatient prescription writing quality.Results: A total of 651 handwritten prescriptions were reviewed in 2005 and 693 in 2010. They contained 1570 drug prescriptions in 2005 (2.4 ± 1.2 drugs per patient) and 1462 in 2010 (2.1 ± 1.1). The most common drugs were paracetamol, ibuprofen, and sodium chloride. A higher proportion of drugs were prescribed as generic names or generics in 2010. Formal data regarding the physicians and the patients were almost complete, except for the patients' weight. Of the drug prescriptions, 48.5% were incomplete, 11.3% were ambiguous, and 3.0% contained an error in 2005. These proportions rose to 64.2%, 15.5% and 7.4% in 2010, respectively.Discussions, Conclusion This study showed that physicians' prescriptions comprised numerous omissions and errors with minimal potential for harm. Computerized prescription coupled with advanced decision support is eagerly awaited.Disclosure of Interest None Declared

On the complementariness of infrasound and seismic sensors for monitoring snow avalanches

The paper analyses and compares infrasonic and seismic data from snow avalanches monitored at the Vallée de la Sionne test site in Switzerland from 2009 to 2010. Using a combination of seismic and infrasound sensors, it is possible not only to detect a snow avalanche but also to distinguish between the different flow regimes and to analyse duration, average speed (for sections of the avalanche path) and avalanche size. Different sensitiveness of the seismic and infrasound sensors to the avalanche regimes is shown. Furthermore, the high amplitudes observed in the infrasound signal for one avalanche were modelled assuming that the suspension layer of the avalanche acts as a moving turbulent sound source. Our results show reproducibility for similar avalanches on the same avalanche path.

Determination of picogram levels of midazolam, and 1- and 4-hydroxymidazolam in human plasma by gas chromatography-negative chemical ionization-mass spectrometry.

Midazolam is a widely accepted probe for phenotyping cytochrome P4503A. A gas chromatography-mass spectrometry (GC-MS)-negative chemical ionization method is presented which allows measuring very low levels of midazolam (MID), 1-OH midazolam (1OHMID) and 4-OH midazolam (4OHMID), in plasma, after derivatization with the reagent N-tert-butyldimethylsilyl-N-methyltrifluoroacetamide. The standard curves were linear over a working range of 20 pg/ml to 5 ng/ml for the three compounds, with the mean coefficients of correlation of the calibration curves (n = 6) being 0.999 for MID and 1OHMID, and 1.0 for 4OHMID. The mean recoveries measured at 100 pg/ml, 500 pg/ml, and 2 ng/ml, ranged from 76 to 87% for MID, from 76 to 99% for 1OHMID, from 68 to 84% for 4OHMID, and from 82 to 109% for N-ethyloxazepam (internal standard). Intra- (n = 7) and inter-day (n = 8) coefficients of variation determined at three concentrations ranged from 1 to 8% for MID, from 2 to 13% for 1OHMID and from 1 to 14% for 4OHMID. The percent theoretical concentrations (accuracy) were within +/-8% for MID and 1OHMID, within +/-9% for 4OHMID at 500 pg/ml and 2 ng/ml, and within +/-28% for 4OHMID at 100 pg/ml. The limits of quantitation were found to be 10 pg/ml for the three compounds. This method can be used for phenotyping cytochrome P4503A in humans following the administration of a very low oral dose of midazolam (75 microg), without central nervous system side-effects.

Prognostication in comatose survivors of cardiac arrest: An advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine.

OBJECTIVES: To review and update the evidence on predictors of poor outcome (death, persistent vegetative state or severe neurological disability) in adult comatose survivors of cardiac arrest, either treated or not treated with controlled temperature, to identify knowledge gaps and to suggest a reliable prognostication strategy. METHODS: GRADE-based systematic review followed by expert consensus achieved using Web-based Delphi methodology, conference calls and face-to-face meetings. Predictors based on clinical examination, electrophysiology, biomarkers and imaging were included. RESULTS AND CONCLUSIONS: Evidence from a total of 73 studies was reviewed. The quality of evidence was low or very low for almost all studies. In patients who are comatose with absent or extensor motor response at ?72h from arrest, either treated or not treated with controlled temperature, bilateral absence of either pupillary and corneal reflexes or N20 wave of short-latency somatosensory evoked potentials were identified as the most robust predictors. Early status myoclonus, elevated values of neuron specific enolase at 48-72h from arrest, unreactive malignant EEG patterns after rewarming, and presence of diffuse signs of postanoxic injury on either computed tomography or magnetic resonance imaging were identified as useful but less robust predictors. Prolonged observation and repeated assessments should be considered when results of initial assessment are inconclusive. Although no specific combination of predictors is sufficiently supported by available evidence, a multimodal prognostication approach is recommended in all patients.

Fungicidal synergism of fluconazole and cyclosporine in Candida albicans is not dependent on multidrug efflux transporters encoded by the CDR1, CDR2, CaMDR1, and FLU1 genes.

The combination of fluconazole (FLC) and cyclosporine (CY) is fungicidal in FLC-susceptible C. albicans (O. Marchetti, P. Moreillon, M. P. Glauser, J. Bille, and D. Sanglard, Antimicrob. Agents Chemother. 44:2373-2381, 2000). The mechanism of this synergism is unknown. CY has several cellular targets including multidrug efflux transporters. The hypothesis that CY might inhibit FLC efflux was investigated by comparing the effect of FLC-CY in FLC-susceptible parent CAF2-1 (FLC MIC, 0.25 mg/liter) and in FLC-hypersusceptible mutant DSY1024 (FLC MIC, 0.03 mg/liter), in which the CDR1, CDR2, CaMDR1, and FLU1 transporter genes have been selectively deleted. We postulated that a loss of the fungicidal effect of FLC-CY in DSY1024 would confirm the roles of these efflux pumps. Time-kill curve studies showed a more potent fungistatic effect of FLC (P = 0.05 at 48 h with an inoculum of 10(3) CFU/ml) and a more rapid fungicidal effect of FLC-CY (P = 0.05 at 24 h with an inoculum of 10(3) CFU/ml) in the FLC-hypersusceptible mutant compared to those in the parent. Rats with experimental endocarditis were treated for 2 or 5 days with high-dose FLC, high-dose CY, or both drugs combined. FLC monotherapy for 5 days was more effective against the hypersusceptible mutant than against the parent. However, the addition of CY to FLC still conferred a therapeutic advantage in animals infected with mutant DSY1024, as indicated by better survival (P = 0.04 versus the results obtained with FLC) and sterilization of valves and kidneys after a very short (2-day) treatment (P = 0.009 and 0.002, respectively, versus the results obtained with FLC). Both in vitro and in vivo experiments consistently showed that the deletion of the four membrane transporters in DSY1024 did not result in loss of the fungicidal effect of FLC-CY. Yet, the accelerated killing in the mutant suggested a "dual-hit" mechanism involving FLC hypersusceptibility due to the efflux pump elimination and fungicidal activity conferred by CY. Thus, inhibition of multidrug efflux transporters encoded by CDR1, CDR2, CaMDR1, and FLU1 genes is not responsible for the fungicidal synergism of FLC-CY. Other cellular targets must be considered.