Résultats du voyage du S.Y. Belgica en 1897-1898-1899 : sous le commandement de A. de Gerlache de Gomery. Rapports scientifiques publiés aux frais du gouvernement belge, sous la direction de la Commission de la Belgica.

R15, Zoologie, Céphalopodes

Dynamic arterial elastance to predict arterial pressure response to volume loading in preload-dependent patients

INTRODUCTION Hemodynamic resuscitation should be aimed at achieving not only adequate cardiac output but also sufficient mean arterial pressure (MAP) to guarantee adequate tissue perfusion pressure. Since the arterial pressure response to volume expansion (VE) depends on arterial tone, knowing whether a patient is preload-dependent provides only a partial solution to the problem. The objective of this study was to assess the ability of a functional evaluation of arterial tone by dynamic arterial elastance (Ea(dyn)), defined as the pulse pressure variation (PPV) to stroke volume variation (SVV) ratio, to predict the hemodynamic response in MAP to fluid administration in hypotensive, preload-dependent patients with acute circulatory failure. METHODS We performed a prospective clinical study in an adult medical/surgical intensive care unit in a tertiary care teaching hospital, including 25 patients with controlled mechanical ventilation who were monitored with the Vigileo(®) monitor, for whom the decision to give fluids was made because of the presence of acute circulatory failure, including arterial hypotension (MAP ≤65 mmHg or systolic arterial pressure <90 mmHg) and preserved preload responsiveness condition, defined as a SVV value ≥10%. RESULTS Before fluid infusion, Ea(dyn) was significantly different between MAP responders (MAP increase ≥15% after VE) and MAP nonresponders. VE-induced increases in MAP were strongly correlated with baseline Ea(dyn) (r(2) = 0.83; P < 0.0001). The only predictor of MAP increase was Ea(dyn) (area under the curve, 0.986 ± 0.02; 95% confidence interval (CI), 0.84-1). A baseline Ea(dyn) value >0.89 predicted a MAP increase after fluid administration with a sensitivity of 93.75% (95% CI, 69.8%-99.8%) and a specificity of 100% (95% CI, 66.4%-100%). CONCLUSIONS Functional assessment of arterial tone by Ea(dyn), measured as the PVV to SVV ratio, predicted arterial pressure response after volume loading in hypotensive, preload-dependent patients under controlled mechanical ventilation.

TRANSITION IN ENDOCRINOLOGY: Hypogonadism in adolescence.

Puberty is a remarkable developmental process with the activation of the hypothalamic-pituitary-gonadal axis culminating in reproductive capacity. It is accompanied by cognitive, psychological, emotional, and sociocultural changes. There is wide variation in the timing of pubertal onset, and this process is affected by genetic and environmental influences. Disrupted puberty (delayed or absent) leading to hypogonadism may be caused by congenital or acquired etiologies and can have significant impact on both physical and psychosocial well-being. While adolescence is a time of growing autonomy and independence, it is also a time of vulnerability and thus, the impact of hypogonadism can have lasting effects. This review highlights the various forms of hypogonadism in adolescence and the clinical challenges in differentiating normal variants of puberty from pathological states. In addition, hormonal treatment, concerns regarding fertility, emotional support, and effective transition to adult care are discussed.

Ontario Medical Association fonds, 1972-1973, 1977-1978, 1980-1982, 1984-1985

This archive contains materials relating to the Ontario Medical Association. The bulk of the materials are correspondence. A complete administrative history of the association is available from, The first 100 years : a history of the Ontario Medical Association / Glenn Sawyer, Toronto : The Association, 1980? (R15 O58 S39 1980).

Veränderung der Entwicklungspotenziale der Region Nordhessen - Eine empirische Bestandsaufnahme

Ziel dieser Studie war es, zu untersuchen, ob sich die relative Position Nordhessens im Wettbewerb mit den umliegenden Regionen seit der im Jahr 2002 durchgeführten Studie im Hinblick auf Indikatoren für die wissensbasierte Entwicklung verbessert hat. Als Ergebnis kann festgehalten werden, dass sich Nordhessen in einem Aufholprozess befindet: Alle relevanten wissensbasierten Indikatoren, wie etwa die Anzahl der Schulabgänger mit Hochschulreife oder der Anteil der Unternehmen, die der Hoch- oder Spitzentechnologie zuzuordnen sind, haben sich positiv entwickelt. In gleicher Weise haben sich alle Indikatoren auch in Relation zur jeweiligen Ausprägung der Nachbarregionen positiv erändert. Relativ gesehen hat sich die Position der Region also verbessert. Absolut betrachtet bleibt es aber dabei, dass die Region in Hinblick auf zentrale Indikatoren der wissensbasierten Entwicklung einen deutlichen Rückstand hat. So liegt die Hochqualifiziertenquote weiterhin 25%, die Anzahl der Unternehmen der Hochtechnologie 50% unter dem Durchschnitt der von uns untersuchten Vergleichsregionen.

Literature in the foreign language syllabus : engaging the student through active learning. 'El rol de la literatura en la enseñanza de la lengua extranjera : la implicación del estudiante en el aula a través del aprendizaje activo'.

Resumen en español. Resumen tomado de la publicación

Combining affective strategies and the Internet for learning second languages. 'La combinación de estrategias afectivas e Internet para el aprendizaje de segundas lenguas'.

Resumen en español. Resumen basado en el de la publicación

El alumnado extranjero en el marco de la educación inclusiva.

Resumen en inglés. Resumen basado en el de la publicación

Enanos, gigantes, princesas y dragones en la Antigüedad Clásica : algunas conexiones entre el cuento tradicional, la literatura infantil y el mito clásico.

Resumen en inglés

La singularidad de las imágenes de la muerte en Emily Dickinson y Carolina Coronado.

Resumen en inglés

Un mosaico de narraciones situadas en la posguerra española : Inés y la alegría (2010) de Almudena Grandes.

Resumen en inglés

Reflexiones sobre el desarrollo profesional del profesorado de Economía.

Resumen en inglés

Evaluation of modelled regional water balance using lake status data: a comparison of 6ka simulations with the NCAR CCM

Variations in lake area and depth reflect climatically induced changes in the water balance of overflowing as well as closed lakes. A new global data base of lake status has been assembled, and is used to compare two simulations for 6 ka (6000 yr ago) made with successive R15 versions of the NCAR Community Climate Model (CCM). Simulated water balance was expressed as anomalies of annual precipitation minus evaporation (P-E); observed water balance as anomalies of lake status. Comparisons were made visually, by comparing regional averages, and by a statistic that compares the signs of simulated P-E anomalies (smoothly interpolated to the lake sites) with the status anomalies. Both CCM0 and CCM1 showed enhanced Northern-Hemisphere monsoons at 6 ka. Both underestimated the effect, but CCM1 fitted the spatial patterns better. In the northern mid- and high-latitudes the two versions differed more, and fitted the data less satisfactorily. CCM1 performed better than CCM0 in North America and central Eurasia, but not in Europe. Both models (especially CCM0) simulated excessive aridity in interior Eurasia. The models were systematically wrong in the southern mid-latitudes. Problems may have been caused by inadequate treatment of changes in sea-surface conditions in both models. Palaeolake status data will continue to provide a benchmark for the evaluation of modelling improvements.