How critical is timing for the diagnosis of influenza in general practice?

QUESTIONS UNDER STUDY: The diagnostic significance of clinical symptoms/signs of influenza has mainly been assessed in the context of controlled studies with stringent inclusion criteria. There was a need to extend the evaluation of these predictors not only in the context of general practice but also according to the duration of symptoms and to the dynamics of the epidemic. PRINCIPLES: A prospective study conducted in the Medical Outpatient Clinic in the winter season 1999-2000. Patients with influenza-like syndrome were included, as long as the primary care physician envisaged the diagnosis of influenza. The physician administered a questionnaire, a throat swab was performed and a culture acquired to document the diagnosis of influenza. RESULTS: 201 patients were included in the study. 52% were culture positive for influenza. By univariate analysis, temperature >37.8 degrees C (OR 4.2; 95% CI 2.3-7.7), duration of symptoms <48 hours (OR 3.2; 1.8-5.7), cough (OR 3.2; 1-10.4) and myalgia (OR 2.8; 1.0-7.5) were associated with a diagnosis of influenza. In a multivariable logistic analysis, the best model predicting influenza was the association of a duration of symptom <48 hours, medical attendance at the beginning of the epidemic (weeks 49-50), fever >37.8 and cough, with a sensitivity of 79%, specificity of 69%, positive predictive value of 67%, negative predictive value of 73% and an area under the ROC curve of 0.74. CONCLUSIONS: Besides relevant symptoms and signs, the physician should also consider the duration of symptoms and the epidemiological context (start, peak or end of the epidemic) in his appraisal, since both parameters considerably modify the value of the clinical predictors when assessing the probability of a patient having influenza.

Sargassum muticum (Yendo) Fensholt, nueva cita para la Peninsula Iberica

Sargassum muticum (Yendo) Fensholt, feofícea originaria de Japón (Pacífico Oeste), está extendiendo rápidamente su área de distribución, asociada a los transportes de ostras japonesas (CRITCHLEY, A. & R. DIJKEMA, Bot. Mar. 27:211-216,1984). Actualmente está citada en el Japón, en la costa Pacífica de América del Norte, en el Atlántico europeo de Inglaterra, Canal de la Mancha y Holanda y en el Mediterráneo francés (CRITCHLEY, A. J. Mar. Biol. Ass. U.K. 63: 617-625, 1983).

Ablation of human colon carcinoma in nude mice by 131I-labeled monoclonal anti-carcinoembryonic antigen antibody F(ab')2 fragments.

Pooled F(ab')2 fragments of three MAbs against distinct epitopes of carcinoembryonic antigen (CEA) were used for radioimmunotherapy of nude mice bearing a subcutaneous human colon carcinoma xenograft. 9-10 d after transplantation when tumor nodules were in exponential growth, 36 mice were treated by intravenous injection of different amounts of 131I-labeled MAb F(ab')2. All 14 mice injected with a single dose of 2,200 (n = 10) or 2,800 microCi (n = 4) showed complete tumor remission. 8 of the 10 mice treated with 2,200 microCi survived in good health for 1 yr when they were killed and shown to be tumor free. Four of nine other mice treated with four fractionated doses of 400 microCi showed no tumor relapse for more than 9 mo. In contrast, all 15 mice injected with 1,600-3,000 microCi 131I-control IgG F(ab')2 showed tumor growth retardation of only 1-4 wk, and 15 of 16 mice injected with unlabeled anti-CEA MAb F(ab')2 showed unmodified tumor progression as compared with untreated mice. From tissue radioactivity distributions it was calculated that by an injection of 2,200 microCi 131I-MAb F(ab')2 a mean dose of 8,335 rad was selectively delivered to the tumor, while the tissue-absorbed radiation doses for the normal organs were: peripheral blood, 2,093; stomach, 1,668; kidney, 1,289; lung, 1,185; liver, 617; spleen, 501; small intestine, 427; large intestine, 367; bone, 337; and muscle, 198. These treatments were well tolerated since out of 19 mice with complete tumor remission only 4 required bone marrow transplantation and 17 were in good health for 6-12 mo of observation. The results demonstrate the selective destruction of established human colon carcinoma transplants by intravenous injection of either single or fractionated doses of 131I-MAb F(ab')2.

[Voyage en Italie : 1824-1830]. , Palais de la Chancellerie. Détails de l'ordre du premier Etage. au dixième de l'Exec[u]tion : [élévation partielle, profils] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 575

Graus de resistência à brusone e produtividade de cultivares melhoradas de arroz de terras altas

O objetivo deste trabalho foi estudar o nível de resistência à brusone nas folhas e panículas e seu efeito sobre a produtividade de 12 cultivares de arroz, em experimento de campo, durante três anos consecutivos. O grau de resistência das cultivares à brusone nas folhas e panículas foi determinado utilizando-se o critério de área sob curva de progresso e severidade de brusone nas panículas dez dias antes de colheita, respectivamente. As cultivares Progresso, Cuiabana, Caiapó, Carajás e Araguaia, em ordem decrescente, foram as mais resistentes à brusone nas folhas. As cultivares Carajás e Progresso apresentaram severidades da brusone, nas panículas, menores do que as demais cultivares em dois anos. A produtividade das cultivares nos três anos de avaliações, que variou de 83 kg/ha na IAC 201 a 3.617 kg/ha na Rio Paraguai, é explicada principalmente pela severidade da brusone nas panículas, já que as correlações foram negativas e significativas. As raças de Pyricularia grisea, IB-9, IB-41, IB-13 e IC-27, provenientes de 13 cultivares, apresentaram interações diferenciais. Os resultados permitiram concluir que o grau de resistência de algumas cultivares é inadequado e necessita de outras medidas de controle.

Négocier avec les Suisses au siècle des Lumières. La "ragion di Stato" à l'épreuve des réformes dans les relations entre Milan et le Corps helvétique (1706-1796).

RESUME : La thèse examine les relations entre le duché de Milan et le Corps helvétique dans l'évolution du système westphalien, à travers l'étude des réformes institutionnelles opérées par les Austro-Lombards sur le territoire milanais au XVIIIe siècle, où le bon voisinage tend à remplacer les traités qui assuraient jusque là les échanges économiques et culturels. L'analyse met en lumière le caractère négocié de ces transformations sur la base de l'étude des pratiques des nouveaux agents issus des milieux militaire et aristocratique. L'étude des anciennes alliances et la permanence de l'héritage espagnol dans ses relations avec le Corps hevétique rendent compte, dans une première partie, des modalités selon lesquelles la raison d'Etat donne à lire la modernité des pratiques austro-lombardes pour intégrer le duché dans la monarchie des Habsbourg. Les trois chapitres suivants saisissent l'impact des réformes qui amorcent une centralisation politique, où le choix des négociateurs milanais reflète la nouvelle situation du duché, dont les tractations frontalières définissent la rationalité du territoire comme limite de l'Autre. Correspondances officielle et privée, mémoires ou autres essais rédigés par les nouvelles élites administratives et diplomatiques milanaises ou viennoises illustrent les modalités selon lesquelles la suppression des anciennes alliances confessionnelles développe un système d'informations politiques pluralistes et sécularisées. Celui-ci se base sur une connaissance politique du voisin helvétique, rapportée par des observateurs mandés comme experts dont la pratique est tributaire des intérêts personnels et de la loyauté envers le monarque. Enfin, les deux dernières parties saisissent la centralité financière et culturelle des villes protestantes suisses, où l'essor bancaire supplante progressivement le système des capitulations militaires mais où les résistances politiques limitent les améliorations en matière de passage ou de sécurité frontalière. L'intense activité éditoriale des centres protestants helvétiques confirme l'attention des élites austro-lombardes sur les modèles d'émancipation économique et culturelle tels que celui de la République de Genève. A la veille d'un nouvel ordre européen, ils rendent compte de l'enchevêtrement des réseaux où émerge une classe de fonctionnaires qui, dans leur mission au service du prince, allient désormais leurs intérêts pour la République des lettres à une volonté de réformer l'Etat.

Simplificação da equação de viabilidade para predizer a longevidade de sementes de milho e soja

A equação de Ellis & Roberts utiliza a temperatura, a umidade e a qualidade inicial da semente para predizer sua longevidade, porém exige experimentos complexos e demorados. O objetivo deste trabalho foi simplificar a equação de viabilidade para predizer a longevidade da semente de milho e soja em condições de armazenamento aberto. A equação simplificada é explicada pelo modelo Vp = Vi - (tgbeta).p, em que Vp é a viabilidade em probit no período p, Vi é a germinação inicial do lote e tgb é a taxa de deterioração da semente para cada espécie. Sementes de milho BRS201 e BRS206 e soja cultivar IAC-8 e MG/BR 46 (Conquista) foram embaladas em sacos de papel e armazenadas por 0, 30, 60, 90, 120, 150, 180, 240, 300 e 360 dias, em galpões abertos, em Sete Lagoas, MG, e Brasília, DF. Os dados foram transformados em 'probit' e a declividade da reta (tgbeta) foi calculada entre 0 e 30 dias. O coeficiente (tgbeta) variou de 1,4767.10-3 a 2,687.10-3 em milho e de 2,868.10-3 a 3,617.10-3 em soja, dependendo das condições climáticas do armazém. A germinação da semente de soja declinou mais rapidamente que a de milho. O modelo prediz com precisão a longevidade das sementes de milho e soja em armazém aberto.

Etude prospective d'évaluation psychiatrique et pédagogique dans un service pour adolescents de la Fondation Santé des Etudiants de France. Méthodologie et résultats préliminaires [Prospective study of psychiatric and pedagogic evaluation of the adolescent service of the Student Health Foundation of France. Methodology and preliminary results].

The present prospective study, with a five-year follow-up, presents an extensive psychiatric and educational assessment of an adolescent population (N = 30) in the age range 14-20, suffering from several psychiatric disorders, though apt to follow a normal academic program. The residential settings where the study took place provide both psychiatric and schooling facilities. In this environment, what is the effectiveness of long-term hospitalization? Are there any criteria for predicting results? After discharge, could social adjustments difficulties be prevented? Assessment instruments are described and the results of one preliminary study are presented. The actual data seems to confirm the impact of the special treatment facilities combining schooling and psychiatric settings on the long term outcome of adolescents.

Seconde lettre à Monsieur l'évêque de Viviers ([Reprod.]) / [Bernard Lambert]

Collection : Les archives de la Révolution française ; 8.575

Pharmacokinetic parameters of artesunate and dihydroartemisinin in rats infected with Fasciola hepatica

OBJECTIVES: The pharmacokinetic (PK) parameters of artesunate, recently discovered to possess promising trematocidal activity, and its main metabolite dihydroartemisinin (DHA) were determined in rats infected with hepatic and biliary stages of Fasciola hepatica and compared with uninfected rats after single intragastric and intravenous (iv) doses. METHODS: Rats infected with F. hepatica for 25 and 83 days and uninfected rats were cannulated in the right jugular vein and blood samples were withdrawn at selected timepoints following 10 mg/kg of iv and a single 100 mg/kg oral dose of artesunate. Plasma was analysed for artesunate and DHA by liquid chromatography coupled to tandem mass spectrometry. RESULTS: Rats harbouring juvenile and adult F. hepatica infections revealed considerable changes in PK parameters of artesunate and DHA. Following oral administration, maximum plasma concentrations (C(max)) of artesunate and DHA were 1.8-2.3-fold higher in infected rats [artesunate: 1334 +/- 1404 ng/mL (no infection) versus 2454 +/- 1494 ng/mL (acute infection) and 2768 +/- 538 ng/mL (chronic infection); DHA: 3802 +/- 2149 ng/mL (no infection) versus 6507 +/- 3283 ng/mL (acute infection) and 9093 +/- 884 ng/mL (chronic infection)]. The AUCs of artesunate and DHA were 2.1-4.4-fold greater in infected rats. An opposite trend was observed after iv injection. C(max) and AUC of artesunate and DHA following iv dosing were 5784 +/- 3718 and 140 938 +/- 128 783 ng.min/mL and 3849 +/- 3060 and 86 107 +/- 41 863 ng.min/mL, respectively, in uninfected rats versus 2623 +/- 1554 and 21 617 +/- 12 230 ng.min/mL and 2835 +/- 980 and 64 290 +/- 29 057 ng.min/mL, respectively, in rats harbouring a chronic infection. The elimination half-lives (t(1/2)) of artesunate and DHA were considerably altered in infected rats following oral and iv administration of artesunate. CONCLUSIONS: F. hepatica infections strongly influence the disposition kinetics of artesunate and its metabolite in rats. The clinical implications of this finding need to be carefully studied.