Transcatheter renal denervation for the treatment of resistant arterial hypertension: the Swiss expert consensus.

Transcatheter (or percutaneous) renal denervation is a novel technique developed for the treatment of resistant hypertension. So far, only one randomised controlled trial has been published, which has shown a reduction of office blood pressure. The Swiss Society of Hypertension, the Swiss Society of Cardiology, The Swiss Society of Angiology and the Swiss Society of Interventional Radiology decided to establish recommendations to practicing physicians and specialists for good clinical practice. The eligibility of patients for transcatheter renal denervation needs (1.) confirmation of truly resistant hypertension, (2.) exclusion of secondary forms of hypertension, (3.) a multidisciplinary decision confirming the eligibility, (4.) facilities that guarantee procedural safety and (5.) a long-term follow-up of the patients, if possible in cooperation with a hypertension specialist. These steps are essential until long-term data on safety and efficacy are available.

Differences in diet between the two largest breeding colonies of Audouin's gulls: the effects of fishery activities

We analysed and compared the diet of Audouin´s gulls Larus audouinii between their two largest breeding sites in the world: the Ebro Delta and the Chafarinas Islands (western Mediterranean). These two localities showed marked differences in the features of the commercial fishing fleet: in the Ebro Delta area a large fishing fleet produced large amounts of discards, while in the Chafarinas the fleet discarded smaller amounts of fish and marine invertebrates, due to the smaller number of vessels. It is also likely that the percentage of discards from total catches is also lower around the Chafarinas than at the Ebro Delta. We distinguished two types of fishing to compare diet compositions: diurnal (only trawling activity) and diurnal and nocturnal (trawling and purse-seine activity, respectively). We also differentiated regurgitates from young nestlings (up to 20 days old) and from older nestlings or adult birds. At the two localities, fish was the main food of Audouin´s gulls, with epipelagic prey (mainly clupeoids) being more important when both diurnal and nocturnal fisheries were operating. This confirms that epipelagic prey either caught actively by the gulls or linked to fisheries was particularly important in the feeding habits of Audouin´s gulls. Nevertheless, differences between the two colonies appear mainly when only trawlers operated: while at the Ebro Delta gulls showed higher consumption of benthic-mesopelagic prey (probably linked to a higher trawler discard availability), gulls from the Chafarinas Islands consumed higher biomass of epipelagic prey probably caught actively at night. When both fleets operated around the two colonies, the average biomass of prey in a regurgitate of younger chicks was significantly higher at the Ebro Delta than at Chafarinas, and the opposite trend was recorded for older nestlings and adults. Niche width was broader in Chafarinas than in the Ebro Delta for both age classes and for any fishing fleet schedule, suggesting again that the exploitation of discards was higher at the Ebro Delta than at the Chafarinas, where gulls showed a more varied diet. Despite the fact that availability of discards was probably higher at the Ebro Delta than at Chafarinas, the per capita availability was not so different at both localities due to the increasing seabird community population at the Ebro Delta, which ca. doubled that at Chafarinas in the last decade.

HIV-pikatestien testaus ja tulosten vertaaminen rutiinidiagnostiikan testituloksiin

Teimme opinnäytetyömme Helsingin ja Uudenmaan sairaanhoitopiirin laboratorion eli HUSLABin virologian osastolla hiv- hepatiittityöpisteessä. Työn tavoitteena oli selvittää kuinka luotettavia immunokromatografiset HIV-pikatestit ovat. Testasimme kolmea eri HIV-pikatestiä ja vertasimme niistä saatuja tuloksia virologian osaston rutiinidiagnostiikan tuloksiin. Pikatestit olivat Determine HIV - 1/2 (Abbott), CORE HIV 1&2 (Core Diagnostics) ja IMMUNOFLOW HIV 1-HIV2 (Core Diagnostics). Testasimme 100 seeruminäytettä jokaisella kolmella HIV-pikatestillä. Näytteistä vahvoja positiivisia oli 20, tuoreita tartuntoja 20, vääriä reaktiivisia 20 ja negatiivisia 40. Tulosten käsittelyssä käytimme SPSS ja Excel -ohjelmia. Tuloksiemme perusteella kaikkien HIV-pikatestien spesifisyys oli parempi kuin niiden sensitiivisyys. HIV-pikatestit eivät antaneet täysin luotettavia tuloksia. HIV-pikatestit eivät välttämättä havaitse tuoreita infektioita ja tämän takia saattaisi tulla vääriä diagnooseja. HIV-pikatestit saattavat myös antaa vääriä positiivisia tuloksia. Testin luotettavuus on hyvä, jos testataan pitkälle edenneitä HIV-infektioita, joissa vasta-aineet ovat korkeita. Tulosten perusteella rutiinidiagnostiikan testeillä HIV-infektio saadaan paremmin diagnosoitua kuin HIV-pikatesteillä. Suomessa ei mielestämme ole tarpeellista käyttää HIV-pikatestejä, sillä laboratoriotekniikka on hyvin kehittynyttä ja välimatkat lyhyitä. Suuren HIV-prevalenssin maissa HIV-pikatestit olisivat mielestämme hyödyllisiä, jotta mahdollisimman moni saataisiin testattua.

Reportage de juin 1940 : un texte engagé ? Genèse et postérité d'un texte emblématique

De 1876 à 1944, des débuts de la Troisième République à sa déportation tragique à Drancy, Max Jacob a été confronté à de nombreux événements historiques nationaux et internationaux : affaire Dreyfus, Grande Guerre, instabilités gouvernementales, crise économique, montée des régimes totalitaires, génocides. Comment s'inscrit-il face à ces événements en tant qu'écrivain d'avant-garde ? Range-t-il l'activité artistique dans une autonomie ? Reste-t-il sur la même position tout au long de son parcours ? Ce volume tente de répondre à ces questions qui sont aussi cruciales que peu évoquées par la critique. S'il est commun de dire que Max Jacob n'est pas un écrivain politiquement « engagé », il reste néanmoins à considérer ses positionnements effectifs dans sa vie comme dans son oeuvre. Ces éléments peuvent être observés à travers des études de sa biographie et de sa pratique épistolaire, mais ce volume accorde également une place importante à sa production poétique.Ces Cahiers présentent les actes de la journée d'étude organisée par l'AMJ le 6 février 2009 à l'université d'Orléans