Relationship between time of day and periprocedural myocardial infarction after elective angioplasty.

Objectives: To test if the time of day significantly influences the occurrence of type 4A myocardial infarction in elective patients undergoing percutaneous coronary intervention (PCI). Background: Recent studies have suggested an influence of circadian rhythms on myocardial infarction size and mortality among patients with ST-elevation myocardial infarction. The aim of the study is to investigate whether periprocedural myocardial infarction (PMI) is influenced by the time of day in elective patients undergoing PCI. Methods: All consecutive patients undergoing elective PCI between 2007 and 2011 at our institutions with known post-interventional troponin were retrospectively included. Patients (n = 1021) were divided into two groups according to the starting time of the PCI: the morning group (n = 651) between 07:00 and 11:59, and the afternoon group (n = 370) between 12:00 and 18:59. Baseline and procedural characteristics as well as clinical outcome defined as the occurrence of PMI were compared between groups. In order to limit selection bias, all analyses were equally performed in 308 pairs using propensity score (PS) matching. Results: In the overall population, the rate of PMI was statistically lower in the morning group compared to the afternoon group (20% vs. 30%, p < 0.001). This difference remained statistically significant after PS-matching (21% vs. 29%, p = 0.03). Multivariate analysis shows that being treated in the afternoon independently increases the risk for PMI with an odds ratio of 2.0 (95%CI: 1.1-3.4; p = 0.02). Conclusions: This observational PS-matched study suggests that the timing of an elective PCI influences the rate of PMI.

Vacuum assisted venous drainage does not increase trauma to blood cells.

Although gravity drainage has been the standard technique for cardiopulmonary bypass (CPB), the development of min imally invasive techniques for cardiac surgery has renewed interest in using vacuum assisted venous drainage (VAVD) Dideco (Mirandola, Italy) has modified the D903 Avant oxygenator to apply a vacuum to its venous reservoir. The impact of VAVD on blood damage with this device is analyzed. Six calves (mean body weight, 71.3 +/- 4.1 kg) were con nected to CPB by jugular venous and carotid arterial cannu lation, with a flow rate of 4-4.51 L/min for 6 h. They were assigned to gravity drainage (standard D903 Avant oxygen ator, n = 3) or VAVD (modified D903 Avant oxygenator, n = 3). The animals were allowed to survive for 7 days. A standard battery of blood samples was taken before bypass, throughout bypass, and 24 h, 48 h, and 7 days after bypass. Analysis of variance was used for repeated measurements. Thrombocyte and white blood cell counts, corrected by hematocrit and normalized by prebypass values, were not significantly different between groups throughout all study periods. The same holds true for hemolytic parameters (lactate dehydrogenase [LDH] and plasma hemoglobin). Both peaked at 24 hr in the standard and VAVD groups: LDH, 2,845 +/- 974 IU/L vs. 2,537 +/- 476 IU/L (p = 0.65), respectively; and plasma hemoglobin, 115 +/- 31 mg/L vs. 89 +/- 455 mg/L (p = 0.45), respectively. In this experimental setup with prolonged perfusion time, VAVD does not increase trauma to blood cells in comparison with standard gravity drainage.

Diabetes mellitus and cancer risk in a network of case-control studies.

Diabetes has been associated to the risk of a few cancer sites, though quantification of this association in various populations remains open to discussion. We analyzed the relation between diabetes and the risk of various cancers in an integrated series of case-control studies conducted in Italy and Switzerland between 1991 and 2009. The studies included 1,468 oral and pharyngeal, 505 esophageal, 230 gastric, 2,390 colorectal, 185 liver, 326 pancreatic, 852 laryngeal, 3,034 breast, 607 endometrial, 1,031 ovarian, 1,294 prostate, and 767 renal cell cancer cases and 12,060 hospital controls. The multivariate odds ratios (OR) for subjects with diabetes as compared to those without-adjusted for major identified confounding factors for the cancers considered through logistic regression models-were significantly elevated for cancers of the oral cavity/pharynx (OR = 1.58), esophagus (OR = 2.52), colorectum (OR = 1.23), liver (OR = 3.52), pancreas (OR = 3.32), postmenopausal breast (OR = 1.76), and endometrium (OR = 1.70). For cancers of the oral cavity, esophagus, colorectum, liver, and postmenopausal breast, the excess risk persisted over 10 yr since diagnosis of diabetes. Our data confirm and further quantify the association of diabetes with colorectal, liver, pancreatic, postmenopausal breast, and endometrial cancer and suggest forthe first time that diabetes may also increase the risk of oral/pharyngeal and esophageal cancer. [Table: see text] [Table: see text].

Reorganization of a deeply incised drainage: role of deformation, sedimentation and groundwater flow

Deeply incised drainage networks are thought to be robust and not easily modified, and are commonly used as passive markers of horizontal strain. Yet, reorganizations (rearrangements) appear in the geologic record. We provide field evidence of the reorganization of a Miocene drainage network in response to strike-slip and vertical displacements in Guatemala. The drainage was deeply incised into a 50-km-wide orogen located along the North America-Caribbean plate boundary. It rearranged twice, first during the Late Miocene in response to transpressional uplift along the Polochic fault, and again in the Quaternary in response to transtensional uplift along secondary faults. The pattern of reorganization resembles that produced by the tectonic defeat of rivers that cross growing tectonic structures. Compilation of remote sensing data, field mapping, sediment provenance study, grain-size analysis and Ar(40)/Ar(39) dating from paleovalleys and their fill reveals that the classic mechanisms of river diversion, such as river avulsion over bedrock, or capture driven by surface runoff, are not sufficient to produce the observed diversions. The sites of diversion coincide spatially with limestone belts and reactivated fault zones, suggesting that solution-triggered or deformation-triggered permeability have helped breaching of interfluves. The diversions are also related temporally and spatially to the accumulation of sediment fills in the valleys, upstream of the rising structures. We infer that the breaching of the interfluves was achieved by headward erosion along tributaries fed by groundwater flow tracking from the valleys soon to be captured. Fault zones and limestone belts provided the pathways, and the aquifers occupying the valley fills provided the head pressure that enhanced groundwater circulation. The defeat of rivers crossing the rising structures results essentially from the tectonically enhanced activation of groundwater flow between catchments.

Trabecular bone score is associated with volumetric bone density and microarchitecture as assessed by central QCT and HRpQCT in Chinese American and white women.

Although high-resolution peripheral quantitative computed tomography (HRpQCT) and central quantitative computed tomography (QCT) studies have shown bone structural differences between Chinese American (CH) and white (WH) women, these techniques are not readily available in the clinical setting. The trabecular bone score (TBS) estimates trabecular microarchitecture from dual-energy X-ray absorptiometry spine images. We assessed TBS in CH and WH women and investigated whether TBS is associated with QCT and HRpQCT indices. Areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry, lumbar spine (LS) TBS, QCT of the LS and hip, and HRpQCT of the radius and tibia were performed in 71 pre- (37 WH and 34 CH) and 44 postmenopausal (21 WH and 23 CH) women. TBS did not differ by race in either pre- or postmenopausal women. In the entire cohort, TBS positively correlated with LS trabecular volumetric bone mineral density (vBMD) (r = 0.664), femoral neck integral (r = 0.651), trabecular (r = 0.641) and cortical vBMD (r = 0.346), and cortical thickness (C/I; r = 0.540) by QCT (p < 0.001 for all). TBS also correlated with integral (r = 0.643), trabecular (r = 0.574) and cortical vBMD (r = 0.491), and C/I (r = 0.541) at the total hip (p < 0.001 for all). The combination of TBS and LS aBMD predicted more of the variance in QCT measures than aBMD alone. TBS was associated with all HRpQCT indices (r = 0.20-0.52) except radial cortical thickness and tibial trabecular thickness. Significant associations between TBS and measures of HRpQCT and QCT in WH and CH pre- and postmenopausal women demonstrated here suggest that TBS may be a useful adjunct to aBMD for assessing bone quality.

Can we afford to add chemotherapy to radiotherapy for glioblastoma multiforme? Cost-identification analysis of concomitant and adjuvant treatment with temozolomide until patient death.

BACKGROUND: Adding temozolomide (TMZ) to standard radiotherapy as a first-line therapy for glioma may increase costs to a disproportionate degree compared with the resulting survival benefits. METHODS: Forty-six consecutive patients (28 males and 18 females; median age, 52 years; age range, 24-70 years) received concomitant TMZ with radiotherapy for 6 weeks followed by adjuvant TMZ for 6 cycles, and they were followed until disease recurrence and then until death. The authors assessed the costs associated with the four phases of treatment from a hospital-centered perspective. RESULTS: Treatment was discontinued early in 3 patients, 9 patients, and 15 patients during concomitant TMZ, before adjuvant TMZ, and during adjuvant TMZ, respectively. Karnofsky index values varied between 85% (at the beginning of treatment) and 76% (at the end of treatment). The nature of care after disease recurrence was diverse. Overall survival ranged from 1.4 months to 64.3 months (median, 15.8 months) and was better if surgical debulking could be carried out before treatment. Global costs amounted to Euros 39,092 +/- Euros 21,948 (concomitant TMZ, Euros 14,539 +/- Euros 4998; adjuvant TMZ, Euros 13,651 +/- Euros 4320; follow-up, Euros 6363 +/- Euros 6917; and recurrence, Euros 12,344 +/- Euros 18,327), with 53% of these costs being related to the acquisition of TMZ; this represented an eightfold increase in cost compared with radiotherapy alone. CONCLUSIONS: TMZ may be an effective but costly adjuvant outpatient therapy for patients with glioblastoma multiforme. Definite cost-effectiveness/utility must be assessed in a randomized Phase III trial.

Pancreatic Trauma in Children

Objectives and Study: To document the demographics, mechanisms and outcome of traumatic pancreatitis in children at a single large tertiary referral centre in Australia. Methods: We undertook a 10-year retrospective audit of children admitted to the Royal Children's Hospital [RCH], Melbourne, Australia with a hospital coded diagnosis which included pancreatic injury between 1993 and 2002. Data included patient demographics, source of admission, mechanism of injury, pancreatic complications, associated injuries, Intensive Care Unit [ICU] admission, results of any operative findings, results of any acute computed tomography (CT) and/or ultrasound (US) imaging of pancreas, selected laboratory findings and length of stay. Results: We identified two distinct groups of patients in the 91 documented cases of pancreatic trauma (median age 8.0 yr, range 0.6-15.8 yr; M:F 2.5:1.0). Fifty-nine had a history of abdominal trauma and elevated serum lipase but no CT or ultrasound evidence of pancreatic injury (Group A). Thirty-two had a history of abdominal trauma, elevated serum lipase but also had CT scan and/or ultrasound evidence of pancreatic injury[Group B]. Patients with ''less severe'' injury based on normal imaging had a lower initial lipase level [Group A, median 651 U/L (interquartile range 520 - 1324) vs, Group B, 1608 U/L (interquartile range 680-3526); P = 0.005] and shorter admission time [Group A, 9.0 days (interquartile range 5.5-15.5) vs Group B, 13.4 days (interquartile range 6.8 - 23.8), P = 0.04]. There were no differences with respect to mortality [Group A, 13.5 % vs Group B, 12.5 %] but patients with evidence of injury on imaging were more likely to have surgical intervention [P = 0.0001]. The single most important overall cause of pancreatic trauma was involvement in a motor vehicle accident as a passenger or pedestrian. However, in children with high-grade ductal injury, bicycle handlebar injuries were most common. Associated injuries were common in both groups. Conclusion: Significant pancreatic injury can occur in the absence of abnormality on medical imaging. Pancreatic trauma commonly occurs in the context of multiple injuries after motor vehicle accidents in children and bicycle handlebar injuries, especially in boys. Most children can be treated conservatively, with surgical intervention being limited to high-grade ductal injury.

Review of the literature on reference pricing

This paper reviews the literature on reference pricing (RP) in pharmaceutical markets. The RP strategy for cost containment of expenditure on drugs is analyzed as part of the procurement mechanism. We review the existing literature and the state-of-the-art regarding RP by focusing on its economic effects. In particular, we consider: (1) the institutional context and problem-related factors which appear to underline the need to implement an RP strategy; i.e., its nature, characteristics and the sort of health care problems commonly addressed; (2) how RP operates in practice; that is, how third party-payers (the insurers/buyers) have established the RP systems existing on the international scene (i.e., information methods, monitoring procedures and legislative provisions); (3)the range of effects resulting from particular RP strategies (including effects on choice of appropriate pharmaceuticals, insurer savings, total drug expenditures, prices of referenced and non-referenced products and dynamic efficiency; (4) the market failures which an RP policy is supposed to address and the main advantages and drawbacks which emerge from an analysis of its effects. Results suggest that RP systems achieve better their postulated goals (1) if cost inflation in pharmaceuticals is due to high prices rather than to the excess of prescription rates, (2) when the larger is the existing difference in prices among equivalent drugs, and (3) more important is the actual market for generics.

Breeding sites of drosophilids (Diptera) in the Brazilian Savanna. I. Fallen fruits of Emmotum nitens (Icacinaceae), Hancornia speciosa (Apocynaceae) and Anacardium humile (Anacardiaceae)

In this study, drosophilids that bred in fruits of three common plant species of the Brazilian Savanna were investigated: Emmotum nitens, Hancornia speciosa and Anacardium humile, along with the temporal and spatial distribution of these insects among fruits obtained from six individuals of E. nitens. Fallen fruits were collected in natural environments, placed on moist sand in individual containers and all drosophilids that emerged from these resources during 15 days were collected, counted and identified. From 3,651 fruits collected (3,435 of E. nitens, 179 of A. humile and 37 of H. speciosa) 4,541 flies emerged and were classified into 19 species of Drosophilidae. Their distribution was unequal among the three resources, also over time, and among the six individuals of E. nitens. Such fluctuations probably reflect the availability of resources in time and space and probably the action of selective factors such as larval competition.

Edad y crecimiento de la Merluza peruana (Merluccius gayi peruanus)

Se determina la edad, y crecimiento de Merluccius gayi peruanus mediante la interpretación de otolitos (Sagita), obtenidos de los muestreos biológicos de la zona de Paita durante el año 1981. Se estudia la formación de los anillos por la naturaleza del borde y se describe el primer anillo anual y el anillo demersal. Se ha establecido la relación longitud del pez con la longitud del otolito, mostrándose en ambos sexos un alto valor del coeficiente de correlación (r > O. 9) . El análisis del crecimiento en longitud, establecido por la ecuación de von Bertalanffy mostró un crecimiento pronunciadamente diferencial entre los sexos, habiéndose determinado una L de 98.8 cm para las hembras y 64.6 para los machos; similares tendencias se encontraron respecto al crecimiento en peso, donde los valores asintóticos fueron de 7,756.7 g y 1,651.3 g para hembras y machos respectivamente. Asimismo se ha establecido la relación tal la/peso, ajustándose a una línea de regresión potencial , calculando las longitudes medias para cada grupo de edad y preparando la clave edad-longitud correspondiente a la zona de Paita. Los valores máximos de edad determinados son de 6 años para machos y de 9 para hembras. Finalmente se comparan l os resultados obtenidos con los correspondientes a otras autores, sobre la misma especie y especies similares, apreciándose consistencia en la inter­pretación de la edad.

Fauna of phlebotomine sand flies (Diptera, Psychodidae) in areas with endemic American cutaneous leishmaniasis in the State of Mato Grosso do Sul, Brazil

Fauna of phlebotomine sand flies (Diptera, Psychodidae) in areas with endemic American cutaneous leishmaniasis in the State of Mato Grosso do Sul, Brazil. The aim of this study was to investigate the ecological aspects of the main vectors of American cutaneous leishmaniasis (ACL) in four monitoring stations situated in the municipalities of Naviraí, Nova Andradina, Novo Horizonte do Sul and Rio Verde de Mato Grosso. For each monitoring station, the captures of sand flies were undertaken each month from July 2008 to June 2010 using CDC and Shannon traps. The CDC traps were installed simultaneously for three consecutive nights in three collection sites: intradomicile, peridomicile and edge of the forest. A Shannon trap was installed from dusk to 10 pm, inside the forest, one night per month. A total of 7,651 sand flies belonging to nine genera and twenty-nine species were captured. Nyssomyia neivai (52.95%), Psathyromyia hermanlenti (10.91%), Psathyromyia runoides (9.16%), Nyssomyia whitmani (7.95%), Psathyromyia aragaoi (4. 89%), Nyssomyia antunesi (3.14%) and Evandromyia bourrouli (2.20%) were the most frequent species. Approximately 65% of the sand flies were collected in the forest environment. The municipalities presented significantly different indexes of species diversity. Naviraí presented the lowest species diversity index, however, it showed the highest abundance. Novo Horizonte do Sul had the highest species diversity index, but the lowest abundance (< 5%). It is noteworthy the occurrence of vector species of Leishmania in the areas studied, especially in Naviraí, where Ny. neivai presented high frequencies which may explain the increased number of ACL cases in this municipality.

Tolerância de genótipos de cafeeiro ao alumínio em solução nutritiva. I. Crescimento e desenvolvimento da parte aérea e sistema radicular

Para estudar a influência do alumínio no crescimento e desenvolvimento de nove genótipos de café, foi instalado um experimento, em janeiro de 1994, em casa de vegetação do Departamento de Fitotecnia da Universidade Federal de Viçosa, situada na Zona da Mata do Estado de Minas Gerais, a uma altitude média de 651 metros. Para tanto, plantas com dois pares de folhas definitivas foram submetidas a 0 e 0,296 mmol L-1 de alumínio em solução nutritiva, com pH 4,0, durante 115 dias. Após este período, as plantas foram divididas em folhas superiores, folhas inferiores, primeiro par de folhas totalmente expandido, caule e raízes, para a determinação da matéria seca. Avaliaram-se, também, altura das plantas, comprimento da raiz principal, número de raízes secundárias e área foliar do primeiro par de folhas totalmente expandido. A presença do alumínio inibiu tanto o crescimento da parte aérea como das raízes, as quais apresentaram anormalidades típicas de toxidez de alumínio. A redução na matéria seca de raízes foi a característica que permitiu melhor discriminação quanto à tolerância ao alumínio entre os genótipos estudados. Observou-se redução no comprimento da raiz principal, na altura das plantas e na área foliar, bem como aumento no número de raízes secundárias em resposta a aumentos das concentrações de Al na solução nutritiva. As características de crescimento avaliadas permitiram discriminar os genótipos em quatro grupos ou categorias: tolerante (UFV 1359, UFV 2149), moderadamente tolerante (UFV 2145, UFV 2877 e UFV 2163), moderadamente sensível (UFV 3880) e sensível (UFV 2147, UFV 2198 e UFV 2237).

Bulles de papes. Titres des maisons de LA JUGIE (1313-1623). — MELANGES (1222-1623).

Contient : Titres de la Jugie ; N° 623 (1) Contrat de mariage de Jacques de la Jugie et de Guillemette de la Borgayrie (23 juillet 1313) ; copie du 18 mars 1314 a. st ; N° 624 (2) Contrat de mariage de Pierre de la Jugie et de Jeanne Pebeyre (août1316) ; restes de sceau sur simple queue ; N° 625 (3) Testament de Geraud de Rajaut, de Tulle, damoiseau (9 août 1329) ; N° 626 (4) Contrat de mariage de Gui Aimoin de Puydeval et d'Hélie de la Jugie (14 décembre 1339) ; N° 627 (5) Donation de biens faite par Guillemette de la Limosnie à Gui de Puydeval, son oncle (30 janvier 1351) ; copie du XVIIe siècle ; N° 628 (6) Accord entre Archambaud, vicomte de Comborn, et Gui de Puydeval (24 mai 1351) ; copie contemporaine ; N° 629 (7) Contrat de mariage de Raimond de Bossac et de Marie de Puydeval (2 août 1352) ; N° 630 (8) Testament de Gui de Puydeval (26 janvier 1371 a. st.) ; copie du XVIIe siècle ; N° 631 (9) Testament de Nicolas de la Jugie, seigneur de Levinerie (26 mars 1374 a. st.) ; vidimus du 18 mai 1402 ; N° 632 (10) Testament de Guillaume de la Jugie, alias de Puydeval (20 août 1397) ; N° 633 (11) Testament d'Aelis de la Jugie (19 juillet 1409) ; N° 634 (12) Décisions prises par divers seigneurs du Limousin, relativement à l'expédition contre les Anglais, pour la levée du siège d'Auberoche (4 septembre 1419) ; N° 635 (13) Contrat de mariage d'Aimar de Puydeval et de Marguerite de Gimel (12 juillet 1426) ; N° 636 (14) Testament d'Hélène de Puydeval, veuve de Jean « de Sadone » (2 juin 1436) ; N° 637 (15) Testament de Jean de la Jugie, alias de Puydeval (7 décembre 1461) ; N° 638 (16) Contrat de mariage de Jean de Sourries, seigneur de Vaur, et d'Anne de Puydeval (29 janvier 1492 a. st.) ; copie, papier ; N° 639 (17) Testament d'Antoine de Puydeval (9 octobre 1495) ; copie du 28 mars 1502, a. st ; N° 640 (18) Contrat de mariage de Pons de Gourdon, seigneur de La Roque, et de Françoise de Puydeval (20 janvier 1497 a. st.) ; copie du 23 août 1579 ; N° 641 (19) Quittance générale donnée par Blanche de Malesec, veuve d'Antoine de Puydeval, à Gilles de Malesec, son frère (23 juin 1512) ; N° 642 (20) Testament de Gabrielle de Puydeval, dame de Miremont (20 mars 1516-1517) ; copie du XVIe siècle ; N° 643 (21) Testament de Denis de Puydeval (18 août 1523) ; copie du XVIe siècle ; N° 644 (22) Quittance générale donnée à Géraud de Puydeval par Pierre de Rajaut et Anne de Puydeval sa femme, 2 août 1534 ; N° 645 (23) Contrat de mariage de Rigaut de Saint-Martial, baron de Conros, et de Françoise de Puydeval (18 juin 1559) ; copie du 22 juillet 1583 ; N° 646 (24) Testament de Géraud de Puydeval (20 mai 1563) ; N° 647 (25) Procès-verbal de visite de bois faite par les arbitres choisis par les seigneurs de Puydeval et de Vaur (5 janvier 1564) ; N° 648 (26) Accord entre Géraud de Puydeval et Bonaventure de Sourries, seigneur de Vaur, au sujet du lieu de La Reynie (21 novembre 1560) ; N° 649 (27) Accord entre Anne de Puydeval, veuve de Jean de Sourries, seigneur de Vaur, et Bonaventure de Sourries (27 septembre 1559) ; N° 650 (28) Testament d'Anne de Puydeval, veuve de Jean [de Sourries, seigneur de] Vaur (8 septembre 1555) ; N° 651 (29) Testament de Jean de Puydeval, doyen de l'église de Tulle ; N° 652 (30) Testament de Françoise de Puydeval, veuve de Rigaut de Saint-Marsal, baron de Conros (16 juin 1601) ; N° 653 (31) Autre testament de ladite dame (22 août 1604) ; N° 654 Copie du précédent testament ; N° 655 (32) Accord entre Josias de Cosnac, seigneur d'Assy, et sa soeur, Marie de Cosnac, femme de Henry de Puydeval, baron de Conros (31 mars 1623 ; N° 656 (33) Contrat de mariage de Pierre de Soudeilles et d'Anne de Puydeval (s. d.) ; N° 657 (33 bis) Copie de la pièce précédente ; Mélanges ; N° 658 (1) Accord entre Guillaume, évêque de Paris, et son chapitre, d'une part, et Philippe-Auguste, de l'autre, au sujet des droits de l'église de Paris (décembre 1222) ; N° 659 (2) Accord entre Philippe le Bel et l'église de Paris pour l'affectation de certaines redevances à la réparation des ponts de la Seine (mars 1296-1297) ; N° 660 (3) Décret de l'Université de Paris établissant des règlements pour le collège de Narbonne, à Paris (4 octobre 1377) ; N° 661 (4) Sentence rendue par Jean, abbé de Saint-Taurin d'Evreux, sur le procès entre Jacques Sacquespée, docteur en médecine, et Jean Daigny, chanoine de la Sainte-Chapelle de Paris (15 mai 1428) ; N° 662 (15) Articles de la Ligue (s. d. [1586 (?)]) ; N° 663 (6) Privilèges accordés par Louis, comte de Flandre, aux marchands castillans trafiquant en Flandre (15 avril 1366) ; copie du XVe siècle ; N° 664 (7) Serment prêté au duc d'Alençon par le chapitre de Cambrai (20 août 1580) ; N° 665 (8) Serment prêté au même personnage par les échevins de la ville de Cambrai (même date) ; N° 666 (9) Aveu rendu à Henri, comte de Rodez, par Pierre de Panat, pour divers fiefs, (juillet 1280) ; N° 667 (10) Aveu rendu par Bernard, comte d'Armagnac et de Rodez, à Guillaume, évêque de Mende, pour les fiefs tenus par ledit comte dans ce diocèse (2 mai 1309) ; N° 668 (11) Autorisation donnée par l'archevêque Michel et le chapitre d'Arles à Jean [de Matha], fondateur de l'Ordre de la Trinité, d'établir une église et un cimetière dans la ville d'Arles (novembre 1203) ; N° 669 (12) Charte de G[uillaume], comte de Forcalquier, abandonnant divers droits à l'église de Ganagobie (10 juin 1206) ; à la suite est transcrite une lettre de A., prieur du dit lieu, à G[uillaume], abbé de Cluny, relative à la donation précédente ; N° 670 (13) Lettres de Charles II, roi de Sicile, comte de Provence, chargeant Hugues de Voisines, senéchal de Provence, de faire sortir du royaume de France la somme de 50.000 livres autorisée par le Roi (24 mars 1297) ; N° 671 (14) Lettres de l'empereur Henri VII, autorisant Gaillard, archevêque d'Arles, à poursuivre la révocation des aliénations de biens ecclésiastiques consenties par ses prédécesseurs (9 juillet 1312) ; N° 672 (15) Lettres de Jean de Clermont, cardinal-évêque de Tusculum, légat du pape dans les provinces de Vienne, Aix, etc., chargeant Jean Ferrier, archevêque d'Arles, de l'assister dans ses fonctions (9 juillet 1533) ; N° 673 (16) Lettres de Raoul de Sendelay, trésorier d'Angleterre, portant donation de terres près de Rouen à Michel de Paris, son ancien serviteur (3 janvier 1445-1446) ; N° 674 (17) Lettre de l'empereur Ferdinand au pape Urbain VIII (28 avril 1635) ; N° 675 (18) Aveu rendu à Bernard, abbé de Charroux, par Jean de Rochefort, pour le château de Saint-Angel (18 mai 1393) ; copie du 17 juillet 1407 ; N° 676 (19) Lettres de l'Université d'Avignon conférant à Pierre Charpin le titre de docteur en droit canon (16 septembre 1405) ; N° 677 (20) Contrat de mariage de Charles d'Apchon, vicomte de Mirmont, et de Lucrèce de Gadaigne (3 août 1579) ; N° 678 (21) Procuration donnée par Philippe de Commynes à Baude Talboein, son secrétaire (9 mars 1474) ; signature autographe ; N° 679 (22) Ratification par Galéas-Marie Sforza du traité conclu en son nom à Amboise entre Tristan Sforza et Louis XI (21 avril 1468) ; N° 680 (23) Lettres d'Etat accordées par le roi Charles VI à Lermite, seigneur de La Faye, son chambellan, envoyé en Angleterre (28 octobre 1407) ; copie du 4 novembre 1407 ; papier ; N° 681 (24) « Plaintes sur le trépas du sage et vertueux chevalier... Jean de La Roche-Aymon ; » pièce de vers (s. d. [1522]) ; miniature en tête ; N° 682 (25) Lettres de Raimond « de Poioliis », archidiacre de Périgueux, recteur du duché de Spolète, pour le paiement de la compagnie de Guillaume de Primat ; N° 683 (26) Lettres de l'Université d'Orléans accordant à Hugues Berthelot le titre de bachelier en droit canon (28 juillet 1409) ; N° 684 (27) Lettres de l'Université d'Orléans au prieur de Marcigny, pour faire pourvoir d'un bénéfice Raoul « Druci », prêtre, licencié en décret (2 septembre 1460 ; N° 685 (28) Lettres de l'Université de Paris à l'abbé de Cluny, pour faire pourvoir d'un bénéfice Jean de Mont, maître ès arts et bachelier en théologie (3 mars 1478-1479) ; N° 686 (29) Lettres de l'Université de Paris à l'abbé de Cluny pour faire pourvoir d'un bénéfice Jean Paulain, maître ès arts (21 février 1538-1539) ; N° 687 (30) Testament de Jacques de Plaigne, seigneur dudit lieu (5 mars 1551-1552) ; copie contemporaine ; N° 688 (31) Contrat de mariage de Pierre de Guasquet et de Marguerite d'Henry (31 mars 1581) ; copie contemporaine ; N° 689 (32) Testament d'Antoine de Guasquet, seigneur de Paramelle (30 août 1585) ; copie contemporaine ; N° 690 (33) Testament de Jean Chantois, sieur de Laumosnerie (30 septembre 1617) ; copie contemporaine ; N° 691 (34) Testament de Claude des Rozières, seigneur de Cherouac (octobre 1623) ; copie contemporaine ; N° 692 (35) Délibération de l'assemblée du clergé de la ville de Reims au sujet de la répartition des deniers à lever sur ledit clergé (30 mars 1585) ; N° 693 (36) Lettre de J[ean de] C[andida] à [Denis Briçonnet], évêque de Saint-Malo (16 novembre, s. d.)

[(18)F]FDG-PET Standard Uptake Value as a Metabolic Predictor of Bone Marrow Response to Radiation: Impact on Acute and Late Hematological Toxicity in Cervical Cancer Patients Treated With Chemoradiation Therapy.

PURPOSE: To quantify the relationship between bone marrow (BM) response to radiation and radiation dose by using (18)F-labeled fluorodeoxyglucose positron emission tomography [(18)F]FDG-PET standard uptake values (SUV) and to correlate these findings with hematological toxicity (HT) in cervical cancer (CC) patients treated with chemoradiation therapy (CRT). METHODS AND MATERIALS: Seventeen women with a diagnosis of CC were treated with standard doses of CRT. All patients underwent pre- and post-therapy [(18)F]FDG-PET/computed tomography (CT). Hemograms were obtained before and during treatment and 3 months after treatment and at last follow-up. Pelvic bone was autosegmented as total bone marrow (BMTOT). Active bone marrow (BMACT) was contoured based on SUV greater than the mean SUV of BMTOT. The volumes (V) of each region receiving 10, 20, 30, and 40 Gy (V10, V20, V30, and V40, respectively) were calculated. Metabolic volume histograms and voxel SUV map response graphs were created. Relative changes in SUV before and after therapy were calculated by separating SUV voxels into radiation therapy dose ranges of 5 Gy. The relationships among SUV decrease, radiation dose, and HT were investigated using multiple regression models. RESULTS: Mean relative pre-post-therapy SUV reductions in BMTOT and BMACT were 27% and 38%, respectively. BMACT volume was significantly reduced after treatment (from 651.5 to 231.6 cm(3), respectively; P<.0001). BMACT V30 was significantly correlated with a reduction in BMACT SUV (R(2), 0.14; P<.001). The reduction in BMACT SUV significantly correlated with reduction in white blood cells (WBCs) at 3 months post-treatment (R(2), 0.27; P=.04) and at last follow-up (R(2), 0.25; P=.04). Different dosimetric parameters of BMTOT and BMACT correlated with long-term hematological outcome. CONCLUSIONS: The volumes of BMTOT and BMACT that are exposed to even relatively low doses of radiation are associated with a decrease in WBC counts following CRT. The loss in proliferative BM SUV uptake translates into low WBC nadirs after treatment. These results suggest the potential of intensity modulated radiation therapy to spare BMTOT to reduce long-term hematological toxicity.