Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 14 de 14
Filter
1.
Ann Pharm Fr ; 80(1): 101-111, 2022 Jan.
Article in French | MEDLINE | ID: mdl-33864805

ABSTRACT

OBJECTIVES: To characterize the engagement of students enrolled in the fifth year of pharmaceutical studies in the management of the health crisis due to the COVID-19 pandemic, and to identify some determinants of this engagement during this period. METHODS: With the health crisis, new missions have been entrusted during hospital internships, whereas certain internship sites were removed in hospitals and as part of the health service organization. In addition, some students who were no longer in internship returned to the hospital setting for helping in critical activities. Student engagement was studied with a questionnaire and focus groups including six or seven students in each group. RESULTS: Forty-three students participated to the study. The answers to the questionnaire highlighted that they were engaged, that they usually did not wait for compensation, and that most of them were satisfied by their activity during the crisis. The thematic analysis demonstrated that despite a feeling of frustration, which was often associated with the interruption of rewarded activities, and despite a stress due to the particular context, student engagement was supported by a better consideration of the pharmacist's role as a professional in public health and by a better acknowledgement of this role by other health professionals. CONCLUSION: This level of engagement is particularly encouraging because it is the witness of the ability of pharmacists to mobilize for general interest, even in adverse context.


Subject(s)
COVID-19 , Pharmaceutical Preparations , Pharmacy , Students, Pharmacy , Humans , Pandemics , SARS-CoV-2
2.
J Hosp Infect ; 112: 16-20, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33636255

ABSTRACT

This study aimed to describe the contamination of sink drains (SDs) with carbapenemase-producing Enterobacterales (CPE) in three intensive care units (ICUs), and to assess the risk of transmission to hospitalized patients. All SDs were sampled monthly for CPE screening by culture. Rectal screening for CPE carriage was conducted weekly for hospitalized patients. CPE were isolated from 22% of SD samples. Some SDs remained colonized with the same strain for several months. No CPE acquisition occurred among hospitalized patients during the study. Certain strategies, such as systematic sampling of SDs in ICUs for screening for contamination by CPE, should be discouraged apart from during outbreaks.


Subject(s)
Enterobacteriaceae Infections , beta-Lactamases , Bacterial Proteins , Disease Outbreaks , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/epidemiology , Enterobacteriaceae Infections/prevention & control , Humans , Intensive Care Units
3.
Med Mal Infect ; 50(3): 252-256, 2020 May.
Article in English | MEDLINE | ID: mdl-31387813

ABSTRACT

OBJECTIVE: Staphylococcusaureus is involved in around 20% of nosocomial pneumonia cases. Vancomycin used to be the reference antibiotic in this indication, but new molecules have been commercialized, such as linezolid. Previous studies comparing vancomycin and linezolid were based on models. Comparing their real costs from a hospital perspective was needed. METHODS: We performed a bicentric retrospective analysis with a cost-minimization analysis. The hospital antibiotic acquisition costs were used, as well as the laboratory test and administration costs from the health insurance cost scale. The cost of each hospital stay was evaluated using the national cost scale per diagnosis related group (DRG), and was then weighted by the stay duration. RESULTS: Fifty-eight patients were included. All bacteria identified in pulmonary samples were S. aureus. The cost of nursing care per stay with linezolid was €234.10 (SD=91.50) vs. €381.70 (SD=184.70) with vancomycin (P=0.0029). The cost of laboratory tests for linezolid was €172.30 (SD=128.90) per stay vs. €330.70 (SD=198.40) for vancomycin (P=0.0005). The acquisition cost of linezolid per stay was not different from vancomycin based on the price of the generic drug (€54.92 [SD=20.54] vs. €40.30 [SD=22.70]). After weighting by the duration of stay observed, the mean cost per hospital stay was €47,411.50 for linezolid and €57,694.0 for vancomycin (NSD). CONCLUSION: These results, in favor of linezolid, support other former pharmacoeconomic study based on models. The mean cost per hospitalization stay was not statistically different between the two study groups, but a trend in favor of linezolid is emerging.


Subject(s)
Cross Infection/drug therapy , Linezolid/economics , Pneumonia, Staphylococcal/drug therapy , Vancomycin/economics , Aged , Costs and Cost Analysis , Cross Infection/economics , Cross Infection/nursing , Diagnosis-Related Groups , Drug Costs , Economics, Nursing , Female , France , Hospitalization/economics , Hospitals, Urban/economics , Humans , Infusions, Intravenous/economics , Length of Stay/economics , Linezolid/administration & dosage , Linezolid/therapeutic use , Male , Middle Aged , Pneumonia, Staphylococcal/economics , Pneumonia, Staphylococcal/nursing , Retrospective Studies , Staphylococcus aureus/drug effects , Vancomycin/administration & dosage , Vancomycin/therapeutic use
5.
Support Care Cancer ; 23(2): 359-64, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25084742

ABSTRACT

Oral mucositis is a major cause of morbidity in high-dose therapy/autologous stem cell transplantation (HDT/ASCT), where microbial colonization has an important pathological implication. In this study, we evaluated the impact of miconazole mucoadhesive buccal tablet (MBT) on mucositis-related complications. During two consecutive 34-month periods, patients treated with HDT/ASCT in our hematology department received either miconazole MBT (60 patients) or conventional oral amphotericin B suspensions three times a day (44 patients) in order to prevent or decrease chemotherapy-induced mucositis. The use of miconazole MBT is associated with less infectious complications as indicated by shorter antibiotic use (7.8 vs. 12.3 days; p < 0.0001), shorter intravenous antifungal use (1.4 vs. 3.6 days; p = 0.02), and a trend towards less yeast contamination in stool samples. Less patients required any analgesic drugs during hospitalization in the miconazole MBT group (18 vs. 7 %; p = 0.09). Indirect indicators of chemotherapy-induced mucositis (duration of hospitalization, morphine use) were in favor of miconazole MBT in patients with multiple myeloma (MM) but not for those with lymphoma. This study suggests that miconazole MBT provides a valid alternative to oral amphotericin B suspensions in regards to mucositis-related complications. A prospective and randomized study is warranted to establish the definite role of miconazole MBT.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Hematopoietic Stem Cell Transplantation/adverse effects , Miconazole/therapeutic use , Mucositis/prevention & control , Stomatitis/prevention & control , Adolescent , Adult , Aged , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Female , Humans , Induction Chemotherapy , Male , Middle Aged , Mucositis/chemically induced , Mucositis/drug therapy , Multiple Myeloma/drug therapy , Prospective Studies , Stomatitis/drug therapy , Tablets , Transplantation, Autologous/adverse effects , Treatment Outcome , Young Adult
6.
Int J Pharm ; 344(1-2): 143-9, 2007 Nov 01.
Article in English | MEDLINE | ID: mdl-17646066

ABSTRACT

Paclitaxel-loaded lipid nanocapsules (PX-LNC) exhibit interesting in vitro characteristics with improved antitumoral activity compared with free PX formulation. Biodistribution studies were realized with the use of (14)C-trimyristin ((14)C-TM) or (14)C-phosphatidylcholine ((14)C-PC) whereas antitumoral activity of PX-LNC formulations was based on the animal survival in a chemically induced hepatocellular carcinoma (HCC) model in Wistar rats. Blood concentration-time profiles for both labeled (14)C-TM-LNC and (14)C-PC-LNC were similar; the t(1/2) and MRT values (over 2h and close to 3h, respectively, for both formulations) indicated the long circulating properties of the LNC carrier with a slow distribution and elimination phase. Survival curves of paclitaxel treated groups showed a statistical significant difference compared to the control survival curve (P=0.0036 and 0.0408). Animals treated with 4x 70 mg/m(2) of PX-LNC showed the most significant increase in mean survival times compared to the controls (IST(mean) 72%) and cases of long-term survivors were preferentially observed in the PX-LNC treated group (37.5%; 3/8). These results demonstrate the great interest to use LNC as drug delivery system for paclitaxel, permitting with an equivalent therapeutic efficiency to avoid the use of excipients such as polyoxyethylated castor oil for its formulation.


Subject(s)
Antineoplastic Agents, Phytogenic/therapeutic use , Nanocapsules , Paclitaxel/therapeutic use , Animals , Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Agents, Phytogenic/pharmacokinetics , Area Under Curve , Biological Availability , Carcinoma, Hepatocellular/chemically induced , Carcinoma, Hepatocellular/drug therapy , Carcinoma, Hepatocellular/mortality , Colloids , Drug Carriers , Drug Compounding , Half-Life , Lipids , Liver Neoplasms, Experimental/chemically induced , Liver Neoplasms, Experimental/drug therapy , Liver Neoplasms, Experimental/mortality , Paclitaxel/administration & dosage , Paclitaxel/pharmacokinetics , Rats , Rats, Wistar , Survival Rate
7.
Hum Mutat ; 28(8): 790-6, 2007 Aug.
Article in English | MEDLINE | ID: mdl-17397038

ABSTRACT

Hirschsprung disease (HSCR) stands as a model for genetic dissection of complex diseases. In this model, a major gene, RET, is involved in most if not all cases of isolated (i.e., nonsyndromic) HSCR, in conjunction with other autosomal susceptibility loci under a multiplicative model. HSCR susceptibility alleles can harbor either heterozygous coding sequence mutations or, more frequently, a polymorphism within intron 1, leading to a hypomorphic RET allele. On the other hand, about 30% of HSCR are syndromic. Hitherto, the disease causing gene has been identified for eight Mendelian syndromes with HSCR: congenital central hypoventilation (CCHS), Mowat-Wilson (MWS), Bardet-Biedl (BBS), Shah-Waardenburg (WS4), cartilage-hair-hypoplasia (CHH), Smith-Lemli-Opitz (SLO), Goldberg-Sprintzsen (GSS), and hydrocephalus due to congenital stenosis of the aqueduct of sylvius (HSAS). According to the HSCR syndrome, the penetrance of HSCR trait varies from 5 to 70%. Trisomy 21 (T21) also predisposes to HSCR. We were able to collect a series of 393 patients affected by CCHS (n = 173), WS4 (n = 24), BBS (n = 51), MWS (n = 71), T21 (n = 46), and mental retardation (MR) with HSCR (n = 28). For each syndrome, we studied the RET locus in two subgroups of patients; i.e., with or without HSCR. We genotyped the RET locus in 393 patients among whom 195 had HSCR, and compared the distribution of alleles and genotypes within the two groups for each syndrome. RET acts as a modifier gene for the HSCR phenotype in patients with CCHS, BBS, and Down syndrome, but not in patients with MWS and WS4. The frequent, low penetrant, predisposing allele of the RET gene can be regarded as a risk factor for the HSCR phenotype in CCHS, BBS, and Down syndrome, while its role is not significant in MWS and WS4. These data highlight the pivotal role of the RET gene in both isolated and syndromic HSCR.


Subject(s)
Alleles , Epistasis, Genetic , Hirschsprung Disease/genetics , Proto-Oncogene Proteins c-ret/genetics , Female , Gene Frequency , Genotype , Humans , Male , Penetrance , Syndrome
9.
Am J Hum Genet ; 69(5): 961-8, 2001 Nov.
Article in English | MEDLINE | ID: mdl-11567216

ABSTRACT

Studies of genetically engineered flies and mice have revealed the role that orthologs of the human LIM homeobox LHX4 have in the control of motor-neuron-identity assignment and in pituitary development. Remarkably, these mouse strains, which bear a targeted modification of Lhx4 in the heterozygous state, are asymptomatic, whereas homozygous animals die shortly after birth. Nevertheless, we have isolated the human LHX4 gene, as well as the corresponding cDNA sequence, to test whether it could be involved in developmental defects of the human pituitary region. LHX4, which encodes a protein 99% identical to its murine counterpart, consists of six coding exons and spans >45 kb of the q25 region of chromosome 1. We report a family with an LHX4 germline splice-site mutation that results in a disease phenotype characterized by short stature and by pituitary and hindbrain (i.e., cerebellar) defects in combination with abnormalities of the sella turcica of the central skull base. This intronic mutation, which segregates in a dominant and fully penetrant manner over three generations, abolishes normal LHX4 splicing and activates two exonic cryptic splice sites, thereby predicting two different proteins deleted in their homeodomain sequence. These findings, which elucidate the molecular basis of a complex Mendelian disorder, reveal the fundamental pleiotropic role played by a single factor that tightly coordinates brain development and skull shaping during head morphogenesis.


Subject(s)
Alternative Splicing/genetics , Dwarfism/genetics , Germ-Line Mutation/genetics , Homeodomain Proteins/genetics , Transcription Factors , Amino Acid Sequence , Base Sequence , Chromosomes, Human, Pair 1/genetics , Cloning, Molecular , DNA Mutational Analysis , Dwarfism/physiopathology , Exons/genetics , Female , Genes, Dominant/genetics , Humans , Introns/genetics , LIM-Homeodomain Proteins , Male , Molecular Sequence Data , Pedigree , Penetrance , Physical Chromosome Mapping , Pituitary Gland/abnormalities , RNA Splice Sites/genetics , RNA, Messenger/analysis , RNA, Messenger/genetics , Rhombencephalon/abnormalities , Sequence Alignment , Skull/abnormalities
10.
J Appl Physiol (1985) ; 91(3): 1274-82, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11509526

ABSTRACT

The aim of this study was to validate a new technique for the measurement of cardiac output (CO) based on ultrasound and dilution (COUD) in anesthetized rats. A transit time ultrasound (TTU) probe was placed around the rat carotid artery, and ultrasound velocity dilution curves were generated on intravenous injections of saline. CO by COUD were calculated from the dilution curves for normal and portal hypertensive rats in which CO was known to be increased. COUD was compared with the radiolabeled microsphere method and with direct aortic TTU flowmetry for baseline CO and drug-induced CO variations. CO in direct aortic TTU flowmetry was the ascending aorta blood flow measured directly by TTU probe (normal use of TTU flowmetry). The reproducibility of COUD within the same animal was also determined under baseline conditions. COUD detected the known CO increase in portal hypertensive rats compared with normal rats. CO values by COUD were correlated with those provided by microsphere technique or direct aortic TTU flowmetry (adjusted r = 0.76, P < 10(-4) and r = 0.79, P < 0.05, respectively). Baseline CO values and terlipressin-induced CO variations were detected by COUD and the other techniques. Intra- and interobserver agreements for COUD were excellent (intraclass r = 0.99 and 0.98, respectively). COUD was reproducible at least 10 times in 20 min. COUD is an accurate and reproducible method providing low-cost, repetitive CO measurements without open-chest surgery. It can be used in rats as an alternative to the microsphere method and to direct aortic flowmetry.


Subject(s)
Cardiac Output/physiology , Lypressin/analogs & derivatives , Ultrasonography/methods , Animals , Antihypertensive Agents/pharmacology , Aorta/physiology , Blood Flow Velocity/drug effects , Blood Flow Velocity/physiology , Blood Pressure/drug effects , Blood Pressure/physiology , Hypertension, Portal/diagnostic imaging , Hypertension, Portal/drug therapy , Hypertension, Portal/physiopathology , Indicator Dilution Techniques , Losartan/pharmacology , Lypressin/pharmacology , Male , Microspheres , Observer Variation , Rats , Rats, Sprague-Dawley , Reproducibility of Results , Terlipressin , Vasoconstrictor Agents/pharmacology
11.
Hum Mol Genet ; 10(14): 1503-10, 2001 Jul 01.
Article in English | MEDLINE | ID: mdl-11448942

ABSTRACT

Hirschsprung disease (HD) has been described in association with microcephaly, mental retardation and characteristic facial features, delineating a syndrome possibly caused by mutations localized at chromosome 2q22--q23. We have analyzed a de novo translocation breakpoint at 2q22 in one patient presenting with this syndrome, and identified a gene, SIP1, which is disrupted by this chromosomal rearrangement. SIP1 encodes Smad interacting protein 1, a new member of the delta EF1/Zfh-1 family of two-handed zinc finger/homeodomain transcription factors. We determined the genomic structure and expression of the human SIP1 gene. Further analysis of four independent patients showed that SIP1 is altered by heterozygous frameshift mutations causing early truncation of the protein. SIP1, among other functions, seems to play crucial roles in normal embryonic development of neural structures and neural crest. Its deficiency, in altering function of the TGF beta/BMP/Smad-mediated signalling cascade, is consistent with some of the dysmorphic features observed in this syndrome, in particular the enteric nervous system defect that underlies HD.


Subject(s)
Abnormalities, Multiple/genetics , Chromosomes, Human, Pair 2/genetics , DNA-Binding Proteins/genetics , Frameshift Mutation/genetics , Hirschsprung Disease/genetics , Mutation , Nerve Tissue Proteins/genetics , Trans-Activators/genetics , Amino Acid Sequence , Chromosome Mapping , Homeodomain Proteins/genetics , Humans , Molecular Sequence Data , Muscular Atrophy, Spinal , RNA-Binding Proteins , Repressor Proteins/genetics , Sequence Homology, Amino Acid , Signal Transduction , Smad Proteins , Transcription Factors/genetics , Translocation, Genetic , Zinc Fingers/genetics
12.
J Hepatol ; 32(3): 434-40, 2000 Mar.
Article in English | MEDLINE | ID: mdl-10735613

ABSTRACT

BACKGROUND/AIMS: Recently, we developed a new method to measure collateral blood flow in rats: splenorenal shunt (SRS) blood flow (BF). The aims were to evaluate the reproducibility of SRSBF measurement in different models of portal hypertension, and to investigate the ability of SRSBF to disclose pharmacological changes. METHODS: Hemodynamics were determined in anesthetized rats with secondary biliary, CCl4 or DMNA cirrhosis and portal vein ligation (PVL) under baseline and pharmacological (octreotide, vapreotide) conditions. The main measurements performed were: SRSBF by the transit time ultrasound (TTU) method and % portosystemic shunts (PSS) by the microsphere method. RESULTS: SRSBF was 6 to 10 times higher in portal hypertensive rats and was similar in the different models of cirrhosis but was higher in portal vein ligated rats than in cirrhotic rats (1.1+/-0.7 vs 0.6+/-0.7 ml x min(-1) x 100 g(-1), p=0.01). SRSBF was correlated with mesenteric %PSS (r=0.61, p<0.01), splenic %PSS (r=0.54, p<0.05), portal pressure (r= 0.32, p<0.05) and the area of liver fibrosis (r=0.33, p<0.05). Octreotide significantly decreased SRSBF (-23+/-20%, p<0.01 vs placebo: -6+/-8%, NS). Vapreotide significantly decreased SRSBF but not mesenteric or splenic %PSS compared to placebo. The variations in SRSBF (-26+/-32%) and in splenic %PSS (0+/-15%) with vapreotide were significantly different (p<0.05) and not correlated (r=-0.1, NS). CONCLUSIONS: Determination of SRSBF by TTU is an accurate way to measure collateral blood flow in different models of intra- and extra-hepatic portal hypertension in rats. Its sensitivity provides accurate measurement of pharmacological changes, unlike the traditional estimation of %PSS by the microsphere method.


Subject(s)
Collateral Circulation , Hypertension, Portal/physiopathology , Splenorenal Shunt, Surgical , Animals , Carbon Tetrachloride , Dimethylnitrosamine , Disease Models, Animal , Hemodynamics/drug effects , Hypertension, Portal/chemically induced , Hypertension, Portal/etiology , Ligation , Male , Octreotide/pharmacology , Portal Vein , Rats , Rats, Sprague-Dawley , Regional Blood Flow/drug effects , Reproducibility of Results , Somatostatin/analogs & derivatives , Somatostatin/pharmacology , Vasoconstrictor Agents/pharmacology
13.
Gastroenterol Clin Biol ; 22(8-9): 697-704, 1998.
Article in English | MEDLINE | ID: mdl-9823558

ABSTRACT

AIMS: The aim of this study was to develop a technique to measure collateral blood flow in portal hypertensive rats. METHODS: Morphological techniques included inspection, casts and angiographies of portosystemic shunts. The main hemodynamic measurements were splenorenal shunt blood flow (transit time ultrasound method), percentage of portosystemic shunts and regional blood flows (microsphere method). In study 1, a model of esophageal varices was developed by ligating the splenorenal shunt. In study 2, morphological studies of the splenorenal shunt were performed in rats with portal vein ligation. In study 3, the relationship between splenorenal shunt blood flow with percentage of portosystemic shunts was evaluated in dimethylnitrosamine cirrhosis. In study 4, secondary biliary, CCl4 and dimethylnitrosamine cirrhosis were compared. In study 5, rats with portal vein ligation received acute administration of octreotide. In study 6, rats with dimethylnitrosamine cirrhosis received acute administration of vapreotide. RESULTS: Blood flow of para-esophageal varices could not be measured. SRS blood flow was correlated with the mesenteric percentage of portosystemic shunts (r = 0.74, P < 0.05), splenic percentage of portosystemic shunts (r = 0.54, P < 0.05) and estimated portosystemic blood flow (r = 0.91, P < 0.01). Splenorenal shunt blood flow was 6 to 12 times higher in portal hypertensive rats, e.g., in portal vein ligated rats: 2.8 +/- 2.7 vs 0.3 +/- 0.1 mL.min-1 in sham rats (P < 0.01), and was similar in the different cirrhosis models but was higher in portal vein ligated rats than in cirrhotic rats (1.2 +/- 0.7 vs 0.6 +/- 0.6 mL.min-1.100 g-1, P = 0.05). Octreotide significantly decreased splenorenal shunt blood flow: -23 +/- 20% (P < 0.01) vs -6 +/- 8% (not significant) in placebo rats. The variation of splenorenal shunt blood flow after vapreotide was significant but not that of the splenic percentage of portosystemic shunts compared to placebo. CONCLUSIONS: The splenorenal shunt is the main portosystemic shunt in rats. The measurement of splenorenal shunt blood flow is easy, accurate and reproducible and should replace the traditional measurement of the percentage of portosystemic shunts in pharmacological studies.


Subject(s)
Collateral Circulation/physiology , Hypertension, Portal/physiopathology , Animals , Hypertension, Portal/diagnostic imaging , Male , Rats , Rats, Sprague-Dawley , Regional Blood Flow , Reproducibility of Results , Splenorenal Shunt, Surgical , Ultrasonography
14.
Hepatology ; 28(5): 1269-74, 1998 Nov.
Article in English | MEDLINE | ID: mdl-9794911

ABSTRACT

The aim of this study was to develop a technique that could serve as an index of portosystemic shunt (PSS) blood flow in portal hypertensive rats whose main shunt is the splenorenal shunt (SRS). The main hemodynamic measurements performed were: SRS blood flow by the transit-time ultrasound (TTU) method, percentage of PSS, and regional blood flows by the microsphere method. We determined the accuracy and reproducibility of SRS blood flow measurements under baseline and pharmacological (octreotide) conditions. SRS blood flow was compared with other hemodynamic characteristics. Two models of portal hypertension were used: secondary biliary and dimethylnitrosamine cirrhosis. The SRS blood flow was correlated with mesenteric (r = .76; P < .001) and splenic (r = .67; P < .01) PSS percentages. The intra- and interobserver agreements for SRS blood flow were excellent: ric = .99 and ric = .98, respectively. SRS blood flow was six times higher in portal hypertensive rats (0.6 +/- 0.7 mL . min-1 . 100 g-1) than in sham rats (0.1 +/- 0.1 mL . min-1 . 100 g-1 [P < .01]). Octreotide significantly decreased SRS blood flow but not mesenteric or splenic PSS percentages. SRS is the main PSS in rats. The measurement of SRS blood flow by TTU is accurate and reproducible. This method can be used to identify new mechanisms in hemodynamic studies that differ from those identified by the measurement of the percentage of PSS by the microsphere method, especially in pharmacological studies.


Subject(s)
Collateral Circulation , Hypertension, Portal/diagnostic imaging , Kidney/blood supply , Spleen/blood supply , Splenorenal Shunt, Surgical , Ultrasonography/methods , Animals , Blood Flow Velocity , Hemostatics/pharmacology , Hypertension, Portal/physiopathology , Male , Octreotide/pharmacology , Rats , Rats, Sprague-Dawley , Reproducibility of Results
SELECTION OF CITATIONS
SEARCH DETAIL
...