Leech therapy is likely to cause symptomatic relief in migraine headache sufferers, but there is little clinical data in this field. This study aimed to investigate the effectiveness of leech therapy ...in the management of migraine headaches.
This is a quasi-experimental pilot study with a three-month post-treatment follow-up. Twenty-six patients with migraine headaches were allocated into two groups to receive either routine drug therapy (Propranolol 80 mg/day and Amytriptyline 50 mg/day) as preventive therapy or leech therapy (1-3 leeches in a single session). The severity and duration of headache were measured before intervention, as well as at week 1, and at months 1, 2, and 3 after intervention. The visual analog scale (VAS) was used to assess the severity of headache.
The mean severity and duration of headaches were significantly decreased within both groups during the study period, whereas there was no significant difference between the groups after three months. The declining trend of severity and duration of headaches was seen to be highly significant in the first week of the treatment in both groups.
The results of this study showed that a single session of leech therapy offers benefits equal to drug therapy in reducing pain in women with migraine headache, and can provide great symptomatic relief, lasting for at least three months.
Moguće je da lečenje pijavicama dovodi do simptomatskog smanjenja tegoba izazvanih glavoboljom. Međutim, postoji malo kliničkih podataka iz ove oblasti. Cilj ove studije bio je da ispita efikasnost terapije pijavicama u lečenju migrenoznih glavobolja.
Ovo je kvazi-eksperimentalna pilot studija sa tromesečnim periodom praćenja nakon sprovedene terapije. Dvadeset šest pacijenata sa migrenoznim glavoboljama bilo je podeljeno u dve grupe, pri čemu je prva grupa primala terapiju lekovima (Propranolol 80 mg/dnevno and Amytriptyline 50 mg/dnevno), dok je druga grupa lečena pijavicama (1-3 pijavice po sesiji). Ozbiljnost i trajanje glavobolja su mereni pre, kao i nakon prve nedelje intervencije i prvog, drugog i trećeg meseca nakon terapije. Za procenu ozbiljnosti glavobolje korišćena je vizuelno analogna skala (VAS).
Srednja vrednost težine i trajanja glavobolja značajno je smanjeno kod obe grupe u toku ispitivanja, dok značajnije razlike između grupa nakon tri meseca nisu utvrđene. Opadajući trend težine i trajanja glavobolje zabeležen je u obe grupe kao visoko značajan u prvoj nedelji terapije.
Rezultati ove studije su pokazali da pojedinačni tretman pijavicama pruža benefite jednake rezultatima terapije lekovima u cilju smanjenja bola kod žena koje pate od migrenoznih glavobolja, kao i da dovodi do simptomatskog olakšanja tegoba koje traje najmanje tri meseca.
A randomized prospective clinical experiment was conducted over two parallel groups of patients who suffer from diabetes mellitus, type 2 and with the diagnosis of distal symmetric sensorimotor ...polyneuropathy (DSMP). The goal of the study is to research and compare the effects of physical procedures and of the treatment with alpha lipoic acid. The study involved two groups of 30 patients each suffering from diabetes mellitus, type 2, and with the diagnosis of DSMP set on the basis of clinical symptoms and signs, as well as on the basis of electromioneurography (EMNG) parameters. The first group (group A) of patients was treated by physical therapy, and the second group (group B) with alpha lipoic acid. According to methodology, the study was conducted during three diagnostic and therapeutic cycles, each of which lasted 16 days, while the period of time between two cycles was 6±1 weeks (total duration of the research was six months). During this period, the patients in the group A were treated with an identical combination of physical agents during 14 days: with pulsed electromagnetic field (PEMF), transcutaneous electrical nerve stimulation (TENS), stable galvanization (SG) and kinesitherapy (KTH). During the physical therapy the electro therapy procedures and magnet therapy were applied first, while the kinesitherapy was applied at the end. In the group B, alpha lipoic acid was used in compliance with the medication producer’s recommendations and the standard clinical practice. During ospitalization, the patients were treated with intravenous infusion of alpha lipoic acid (600mg in 500ml 0,9% NaCl) in the conditions protected from light, 90 minutes per day, during 14 days in the time interval from 08hrs to 10hrs. After the period of hospitalization and during the whole period of the research, the patients continued to regularly take 600mg of alpha lipoic acid perorally (one tablet per day, in the morning before breakfast). The results show that in treatment of distal symmetric diabetes polyneuropathy both therapy methods that were under research (physical therapy and use of alpha lipoic acid) have positive effects in terms of pain reduction, improvement of quality of life, improvement of electromioneurography results for peripheral nerves and strengthening of leg muscles. The therapy by combined physical procedures has better effect on pain reduction and muscle strengthening, while on the other hand the use of alpha lipoic acid has additional positive effect on biochemical parameters for regulation of glucose and lipids.
Sprovedeno je randomizovano eksperimentalno kliničko prospektivno istraživanje, u dve paralelne grupe ispitanika koji boluju od dijabetes melitusa tip 2 i kod kojih je postavljena dijagnoza distalne simetrične dijabetesne senzomotorne polineuropatije (DSMP) u cilju da se ispita i uporedi efekat fizikalnih procedura i tretmana alfalipoičnom kiselinom. U studiju su bile uključene dve grupe od po 30 pacijenata obolelih od dijabetes melitusa tip 2, kod kojih je na osnovu kliničkih simptoma i znakova, kao i parametara elektromioneurografskog (EMNG) nalaza postavljena dijagnoza DSMP. Prva grupa (grupa A) ispitanika je tretirana fizikalnom terapijom, a kod druge grupe ispitanika (grupa B) je bila primenjena alfalipoična kiselina. Protokol studije je podrazumevao da je studija sprovedena tokom tri dijagnostičko-terapijska ciklusa, svaki od njih je trajao 16 dana, a vremenski period između dva ciklusa je bio 6±1 nedelja (ukupno trajanje studije je šest meseci). U Grupi A, u ovom periodu, pacijenti su lečeni identičnom kombinacijom fizikalnih agenasa tokom 14 dana: pulsirajućim elektromagnetnim poljem (PEMP), transkutanom električnom neuralnom stimulacijom (TENS), stabilnom galvanizacijom (SG) i kineziterapijom (KTH). Prilikom primene fizikalne terapije prvo su se sprovele elektroterapijske procedure i magnetoterapija (nije bitan redosled sprovođenja terapija), a na kraju je sprovedena kineziterapija. U Grupi B je primenjena alfalipoična kiselina u skladu sa preporukom proizvođača leka i standardnom kliničkom praksom. Tokom hospitalizacije pacijenti su lečeni intravenskom aplikacijom preparata alfalipoične kiseline (600 mg u 500 ml 0,9% NaCl). Aplikacija se odvijala u uslovima zaštite od svetla, tokom 90 minuta, u vidu intravenske infuzije, svakodnevno, tokom 14 dana u vremenskom periodu od 08:00 do 10:00. Po završenoj hospitalizaciji, a tokom celog perioda studije, ovi ispitanici su nastavljali da redovno uzimaju peroralno preparat alfalipoične kiseline u dozi od 600 mg (jedna tableta dnevno, ujutru pre doručka). Pokazano je da u lečenju distalne simetrične dijabetesne polineuropatije oba ispitivana terapijska modaliteta (fizikalna terapija i primena alfalipočne kiseline) imaju koristan efekat u smislu redukcije bola, poboljšanja kvaliteta života, poboljšanja elektromioneurografskog nalaza perifernih nerava i poboljšanja mišićne snage muskulature donjih ekstremiteta. Terapija kombinovanim fizikalnim procedurama ima izrazitiji efekat na redukciju bola i povećanje mišićne snage, dok primena alfalipoične kiseline je imala dodatni koristan efekat na biohemijske parametre glikoregulacije i liporegulacije.
The etiology of DDH, except "conditions" which allows pelvic presentation, there is multifactoriality, which includes in addition to genetic and hormonal and mechanical factors. It is believed that ...both the pelvic presentation and method of delivery of infants with breech presentation a significant risk factor DDH. About 3 - 4% of children born in breech presentation. Hypotheses 1. Mode of delivery on the prevalence of developmental dysplasia of the hip in children 2. Time of birth (gestational time) on the prevalence of developmental dysplasia of the hip 3. Position the fruit on the prevalence of developmental dysplasia of the hip, regardless of delivery method. The purpose and goal of the research 1. To determine the degree of correlation of developmental dysplasia of the hip in relation to the way delivery 2. To determine which factors affect the incidence of developmental of the hip in infants with breech presentation, and frequency of delivery with pelvic prezentation. 3.To determine the effect of breech presentation on developmental disorder hips 4.To determine whether the incidence of DDH in term babies with breech presentation depends on the type of delivery This study was designed as a "Case - control" studies or "case - Control. "Cases were infants with breech presentation who developed postpartum developmental dysplasia of the hip (DDH) and control infants with breech presentation who did not develop DDH. Population that we studied, and we took out the cases and controls were infants with breech presentation who were born in the Gynecology and Obstetrics Department of Health Center Novi Pazar from 01.01. 2004 to 31 12th 2011th year. During the study 17 600 births monofoetal 594 newborn even born breech presentation. Of 594 infants with breech presentation DDH is developed, and it consisted of a group of cases, 113 infants born breech, not the act of DDH developed the control group. Ehosonographic objectification of the findings of the hip was performed newborns graphs methodological approach in the Ultrasound Department of pediatric surgery clinic HC Novi Pazar. In this study, mothers with breech presentation infants, who had a developmental disorder of the hip (DDH), were on average older, less gestational age at delivery and similar parity and mothers without DDH. Review of the clinical characteristics of infants by sex, showed that they do not differ significantly. In our study, we noted a significantly higher representation of mothers aged 20 in the control group than the study group (21.2% vs. 5.7%), while in the age interval of 30-34 years older than mothers tested controls (17.92% vs. 8.87%) . (P = 0.001, Mann-Whitney U test = 6040.5). appreciably larger representation mothers in the 37th week of pregnancy in the study group (16.4%) and higher prevalence of mothers in 40th week of pregnancy in the control group (52.2%). (%). (p<0.0001, Mann- Whitney U test=5228.). Hence it is that the children of mothers born before the study group compared to healthy children, which means that early labor / delivery time) can be a factor for DDH. Also, the use of a particular mode of delivery did not influence the sex of newborns. The point of the study was rerouted to determine risk factors in DDH after breech presentation. Based on research and experience in this type of delivery, the set of possible hypotheses,relevant factors. In accordance with most authors, the influence of age and parity of mothers, the estimated weight neonates, are crucial for the selection of the type of delivery method and delivery of the key conditions for DDH, after breech presentation. Significantly higher incidence of primiparas who gave birth to planned Caesarean section in a group where there was no DDH newborns suggests that it is the method of choice in breech presentation, which can be prevented with DDH. There are researchers who explicitly advocate such a position. When it comes to elective Caesarean section, this study has shown that in the case of planned Caesarean section primiparous women giving birth significantly greater age, the lower Apgar scores were at the birth of DDH, compared to primiparae without DDH. Of the total number of observed total hip control group (25.8%) were in the category of risk progradirala hips. From the above paragraph it can be concluded that in almost a quarter of infants with breech presentation who were the first ultrasound at six weeks had normal findings on the control of six months there is a progression in the risk hip ratio and is therefore required to control the hips six months. Summing up the findings after a comprehensive analysis of the rezultata istraživanja, it was discovered that the way childbirth affects the occurrence of DDH, the highest incidence of DDH in primipara, the planned cesarean section has a protective effect on the occurrence of DDH, and that most cases of DDH in babies born vaginal and emergency caesarean section.
Uzrok i nastanak razvojnog poremećaja kuka kod dece (RPK ) je stalno u žiži interesovanja, od prvih radova pa sve do današnjih dana i još nije do kraja razjašnjen. Smatra se da su oboje i karlična prezentacija i način porođaja ovorođenčadi sa karličnom prezentacijom značajan faktor rizika za nastanak razvojnog porermećaja kuka. Oko 3 - 4% dece rodi se karličnom prezentacijom. Hipoteze istraživanja 1. Način porođaja utiče na pojavu razvojnog poremećaja kukova kod dece 2. Vreme porođaja ( gestacijsko vreme ) utiče na pojavu 117 razvojnog poremećaja kukova 3. Položaj ploda utiče na pojavu razvojnog poremećaja kukova bez obzira na način porođaja. Svrha i cilj istraživanja 1. Da se utvrdi stepen korelacije razvojnog poremećaja kukova u odnosu na način porođaja 2. Da se utvrdi koji faktori utiču na učestalost razvojnog poremećaja kuka u novorođenčadi sa karličnom prezentacijom,kao i učestalost porođaja sa karličnom prezentacijom. 3. Da se utvrdi uticaj karlične prezentacije na razvojni poremećaj kukova 4.Da se utvrdi da li je učestalost RPK u terminski porođenih beba sa karličnom prezentacijom zavisna od načina porođaja. Ovo istraživanje je dizajnirano kao „ kejs – kontrol “studija , odnosno „ slučaj –kontrola “.Slučajevi su novorođenčad sa karličnom prezentacijom koja su nakon porođaja razvila razvojni poremećaja kuka(RPK) a kontrole novorođenčad sa karličnom prezentacijom koja nisu razvila RPK. Populacija koju smo istraživali i iz koje smo uzimali i slučajeve i kontrole su novorođenčad sa karličnom prezentacijom koja su rođena na Ginekološko akušerskom odeljenju ZC Novi Pazar u periodu od 01.01. 2004 godine do 31. 12. 2011. godine. Tokom istraživanja na 17600 monofetalnih porođaja 594 novorođečeta je rođeno karličnom prezentacijom. Od 594 novorođenčadi sa karličnom prezentacijom 140 je razvilo RPK, i ona su činila grupu slučajeva, 113 novorođenčadi rođeno karlično koja nisu razvila RPK činalo je kontrolnu grupu. Ehosonografska objektivizacija nalaza na kuku novorođenčadi vršena je Grafovim metodološkim postupkom iz protokola - ultrazvučno pregledanih u ultrazvučnom kabinetu dečje hirurške ambulante ZC Novi Pazar. U ovom istraživanju porodilje sa karličnom prezentacijom novorođenčadi, koji su imali razvojni poremećaj kukova(RPK), bile su u proseku starije, manje gestacijske starosti na porođaju i sličnog pariteta kao i porodilje bez RPK. Razmatranje kliničkih karakteristika novorođenčadi po polu, pokazalo je da se oni ne razlikuju značajno. U našem istraživanju smo konstatovali znatno veću zastupljenost porodilja do 20 godina starosti u kontrolnoj grupi nego u ispitivanoj (21.2% prema 5.7%), dok je u starosnom intervalu od 30-34 godina više porodilja ispitivane nego kontrolne grupe (17.92% prema 8.87%). (p=0.001, Mann-Whitney U test=6040.5). Primetna je veća zastupljenost porodilja u 37 .nedelji trudnoće u ispitivanoj grupi (16,4%) i veća zastupljenost porodilja u 40 . nedelji trudnoće u kontrolnoj grupi (52,2%). (p<0.0001, Mann-Whitney U test=5228.). Na osnovu toga sledi da su se deca porodilja ispitivane grupe rađala ranije u odnosu na decu kontrolne grupe , što znači da raniji porođaj /vreme porođaja) može biti faktor za nastanak RPK. Takođe, ni primena određenog načina porođaja nije zavisila od pola novorođenčadi. Poenta rada bila je preusmerena na utvrđivanje faktora rizika na RPK nakon karlične prezentacije ploda. Na osnovu dosadašnjih istraživanja i iskustva u ovoj vrsti porođaja, postavljene su hipoteze o mogućim, relevantnim činiocima. Saglasno većini autora, uticaj starosne dobi i pariteta porodilje, procenjena telesna masa neonatusa, ključni su za izbor načina porođaja, a način porođaja je od bitnih uslova za RPK, nakon karlične prezentacije.Značajno veća zastupljenost prvorotki koje su se porađale planiranim carskim rezom u grupi gde nije bilo RPK novorođenčadi navodi na zaključak da je to metod izbora u karličnoj prezentaciji, čime se može prevenirati RPK. Ima istraživača koji decidirano zastupaju ovakav stav. Kada je u pitanju planirani carski rez, ovo istraživanje je pokazalo da su se u slučaju prvorotki planiranim carskim rezom porađale žene znatno veće starosne dobi, da je niži apgar skor bio na rođenju sa RPK, u odnosu na prvorotke bez RPK.Od ukupnog broja posmatranih kukova kontrolne grupe ukupno (25.8%) su progradirala u kategoriju rizičnih kukova. Iz gore navedenog stava se da zaključiti da kod skoro četvrtine novorođenčadi sa karličnom prezentacijom koja su na prvom ultrazvučnom pregledu sa šest nedelja imalanormalan nalaz, na kontroli sa šest meseci dolazi do progresije u rizičan kuk te je zbog toga obavezna kontrola kukova sa šest meseci. Sumiranjem zaključaka nakon sveobuhvatne analize dobijenih rezultata istraživanja, došlo se do saznanja , da način porođaja utiče na pojavu RPK, da je najveća učestalost RPK u prvorotki , da planirani carski rez deluje protektivno na pojavu RPK,a da je najveći broj slučajeva RPK u novorođenčadi porođenih vaginalno i hitnim carskim rezom.
Over the past 10 years, functional assessment before surgical treatment of lung cancer has changed significantly. Not only have they changed the limits for ventilation parameters in terms of safe ...resection, but also a highly sophisticated method of prediction of postoperative lung function and operational risk assessments have become routine Furthermore, only age is no longer a contraindication for surgery, and more older people who have the ability obstacle after surgical treatment. The impact of physical therapy on the outcome of lung resection is still controversial. How can physical therapy now used routinely by most candidates for surgery, regardless of their readiness for surgery is particularly difficult to analyze the specific contribution of the treatment outcome of surgical treatment. Goal The aim of this study was to assess the contribution of physical therapy postoperative pulmonary function and exercise tolerance in patients with COPD who underwent surgical treatment of lung cancer, based on comparisons of preoperative respiratory function tests and exercise tolerance before and after physical therapy using the same tests conducted after the surgery, as well as comparison of these patients with a group of patients without preoperative saHOBP physical therapy. Materials and Methods The study included a total of 180 consecutive patients who were tested, treated and operated on by the same medical team and the same protocols. All patients had primary lung cancer. These patients were divided into two groups: one group consisted of patients with COPD, n = 130, a long group patients who did not have COPD, n = 50 Group of patients who had COPD were divided into two subgroups on the basis of whether they had preoperative pulmonary rehabilitation (PPR) or had no PPR. One subgroup of patients, n = 83, had been in the preoperative period dosed and controlled preoperaivnu pulmonary rehabilitation (PPR) and other groups of patients, n = 47, had no PPR. The second group of patients who did not have COPD, also were divided into two subgroups, one subgroup that had a PPR, n = 30, and the other subgroup n = 20, which had no PPR. Results In patients with tumors where it was necessary to make a lobectomy after preoperative physical therapy, registered a highly significant increase in FEV1, VC, FEF50 and FEF25 the initial values. After physical therapy achieved a significant improvement compared to the distance covered during the 6MWD. After lung resection, there was a significant reduction in FEV1 and VC with a significant worsening of the small airways function, exercise tolerance and current symptomatology. After surgery, there was a clear tendency for a smaller reduction of FEV1 in patients with moderate to severe impairment of lung function compared with patients with mild initial impairment. Higher increase in FEV1 was associated with a significant reduction in FEV1 Conclusion Our result confirms that pulmonary rehabilitation is an important part of the preoperative and postoperative treatment in patients with COPD who underwent lung resection for lung cancer.
Tokom poslednjih 10 godina, funkcionalna procena prehirurškog lečenja karcinoma pluća značajno se izmenila. Ne samo da su se izmenile granične vrednosti parametara ventilacije u pogledu bezbedne resekcije, već su i visoko sofisticirani metodi predvidjanja postoperativne plućne funkcije i procena operativnog rizika postali rutinski postupak Osim toga, samo životno doba više ne predstavlja kontraindikaciju za hirurško lečenje, pa je sve više starijih osoba koje nakon prePR imaju mogućnost hiruškog lečenja. Uticaj fizikalne terapije na ishod resekcije pluća je još uvek kontroverzan. Kako se fizikalna terapija danas rutinski koristi kod većine kandidata za hirurško lečenje, bez obzira na njihovu spremnost za hirurško lečenje, teško je posebno analizirati specifičan doprinos ovog tretmana ishodu hirurškog lečenja. Cilj. Cilj ovog ispitivanja je procena doprinosa fizikalne terapije postoperativnoj plućnoj funkciji i podnošenju napora kod pacijenata sa HOBP podvrgnutih hirurškom lečenju karcinoma pluća, a na osnovu poredjenja preoperativnog testiranja respiratorne funkcije i podnošenja napora pre i posle fizikalne terapije pomoću istih testova sprovedenih postoperativno, kao i uporedjivanje ovih pacijenata sa grupom pacijenata sa HOBP bez preoperativne fizikalne terapije. Materijal i metod. Istraživanjem je obuhvaćeno ukupno 180 konsekutivnih bolesnika koji su ispitivani, lečeni i operisani od strane istog lekarskog tima i prema istim protokolima. Svi bolesnici su imali primarni karcinom pluća. Ove bolesnike smo podelili u dve grupe: jednu grupu su činili bolesnici sa HOBP,( n=130), a dugu grupu bolesnici koji nisu imali HOBP, (n=50). Grupu bolesnika koji su imali HOBP podelili smo na dve podgrupe, na osnovu toga da li su imali preoperativnu plućnu rehabilitaciju(PPR) ili nisu imali PPR. Jedna podgrupa bolesnika, ( n=83), imali su u preoperativnim periodu doziranu i kontrolisanu preoperaivnu plućnu rehabilitaciju (PPR) i druga podgrupa bolesnika, (n=47), nisu imali PPR. Drugu grupu bolesnika koji nisu imali HOBP, takodje smo podelili u dve podgrupe, jednu podgrupu koja je imala PPR, (n=30), i drugu podgrupu ( n=20), koja nije imala PPR. Rezultati Kod pacijenata sa karcinomom pluća gde je bilo potrebno načiniti lobektomiju, posle preoperativne fizikalne terapije, registrovano je visoko signifikantno povećanje FEV1, VC, FEF50 i FEF25 prema početnim vrednostima. Posle fizikalne terapije ostvareno je signifikantno poboljšanje u odnosu na pređeno rastojanje u toku 6MWD. Nakon resekcije pluća, došlo je do značajnog smanjenja FEV1 i VC uz značajno pogoršanje funkcije malih disajnih puteva, podnošenja napora i postojeće simptomatologije. Nakon hirurškog zahvata, postojala je jasna tendencija manjem smanjenju FEV1 kod pacijenata sa umerenim do teškim oštećenjem plućne funkcije u poredjenju sa pacijentima sa blagim početnim oštećenjem. Veće poboljšanje FEV1 bilo je udruženo sa značajnijim smanjenjem FEV1 Zaključak. Dobijni rezultati potvrdjuju da plućna rehabilitacija predstavlja važan deo preoperativnog i postoperativnog lečenja kod bolesnika sa HOBP koji su podvrgnuti resekciji pluća zbog karcinoma pluća.
Since the discovery of the antitumor activity of cisplatin by Rosenberg and co-workers, the use of metal complexes in cancer treatment has caused a huge interest. Today, platinum-based drugs are part ...of standard chemotherapy in the management of a variety of ca ncers, germ cell tumours, sarcomas, and lymphomas. Unfortunately, toxicity and drug resistance are major obstacles to wider clinical application of these drugs. Their use is greatly limited by severe side effects such as nephrotoxicity, ototoxicity, and neurotoxicity. Although cisplatin is one of the most successful anticancer drugs to date, its biochemical mechanism of action is still unclear. Cisplatin is generally accepted as having the ability to interact with the purine bases on the DNA, causing DNA damage, interfering with DNA repair mechanisms, and subsequently inducing apoptosis in cancer cells.
Chronic lymphocytic leukaemia is a neoplastic B cell lymphoproliferative disease characterized by a highly variable clinical course. Clinical stage at the diagnosis and biological prognostic factors are the important predictors for survival. The Rai and Binet staging systems describe three major prognostic subgroups. Commonly used prognostic biomarkers in chronic lymphocytic leukaemia can be divided into genotypic, DNA-level changes and phenotypic, expression-level changes. For chronic lymphocytic leukaemia, substantial progress in therapy has not been made over the past 40 years. The main goal of future scientific research is to find new platinum complexes that have better efficacy in cancer treatment, the ability to be administered orally, without developing a cancer-drug resistance, and reduced toxic side effects.
Portrait medal Parijse Munt; Fix-Masseau, Pierre-Félix
1929
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Ronde bronzen portretpenning
Paul Lecène was anatomisch-pathologisch chirurg te Parijs en schrijver van o.a. 'L'évolution de la chirurgie'. Hij is aan de voorzijde en profil naar rechts afgebeeld; de ...keerzijde is glad. Van Pierre-Félix Fix-Masseau (1869-1937) (gegevens uit Bénézit) bezit de Johns Hopkins University collectie niet deze, wel een andere penning uit 1909.
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