Cardiologie. Tests de réactivité plaquettaire: mise à jour pour le praticien [Cardiology. Platelet function testing for clinicians].

Platelet P2YI2 receptor inhibition with clopidogrel, prasugrel or ticagrelor plays a key role to prevent recurrent ischaemic events after percutaneous coronary intervention in acute coronary syndromes or elective settings. The degree of platelet inhibition depends on the antiplatelet medication used and is influenced by clinical and genetic factors. A concept of therapeutic window exists. On one side, efficient anti-aggregation is required in order to reduce cardio-vascular events. On the other side, an excessive platelet inhibition represents a risk of bleeding complications. This article describes the current knowledge about some platelet function tests and genetic tests and summarises their role in the clinical practice.

The UEFA EURO 2012 anti-doping programme - scientific review

The final tournament of the UEFA European Football Championship is one of the top sporting events in the world, and a high-profile event of this kind requires a well-planned and well-executed anti-doping programme to ensure the integrity of results in the competition. UEFA EURO 2012 presented a unique logistical challenge, with the tournament spread across two countries, both covering a large geographical area. This paper discusses the planning and delivery of both the pre tournament out-of-competition (OOC) testing programme and the in-competition (IC) programme, as well as reviewing the activities of doping control officers (DCOs), the whereabouts programme and assessing the sample collection and transport process. The analytical approach applied is also discussed, along with an overview of the distribution of T/E ratios and blood parameters.

A phase IIa randomized clinical study testing GNbAC1, a humanized monoclonal antibody against the envelope protein of multiple sclerosis associated endogenous retrovirus in multiple sclerosis patients - A twelve month follow-up.

GNbAC1 is a humanized monoclonal antibody targeting MSRV-Env, an endogenous retroviral protein, which is expressed in multiple sclerosis (MS) lesions, is pro-inflammatory and inhibits oligodendrocyte precursor cell differentiation. This paper describes the open-label extension up to 12months of a trial testing GNbAC1 in 10 MS patients at 2 and 6mg/kg. The primary objective was to assess GNbAC1 safety, and other objectives were pharmacokinetic and pharmacodynamic assessments. During the extended study, no safety issues occurred in the 8 remaining patients. No anti-GNbAC1 antibodies were detected. GNbAC1 appears well tolerated.

Preparation of a blood culture pellet for rapid bacterial identification and antibiotic susceptibility testing.

Bloodstream infections and sepsis are a major cause of morbidity and mortality. The successful outcome of patients suffering from bacteremia depends on a rapid identification of the infectious agent to guide optimal antibiotic treatment. The analysis of Gram stains from positive blood culture can be rapidly conducted and already significantly impact the antibiotic regimen. However, the accurate identification of the infectious agent is still required to establish the optimal targeted treatment. We present here a simple and fast bacterial pellet preparation from a positive blood culture that can be used as a sample for several essential downstream applications such as identification by MALDI-TOF MS, antibiotic susceptibility testing (AST) by disc diffusion assay or automated AST systems and by automated PCR-based diagnostic testing. The performance of these different identification and AST systems applied directly on the blood culture bacterial pellets is very similar to the performance normally obtained from isolated colonies grown on agar plates. Compared to conventional approaches, the rapid acquisition of a bacterial pellet significantly reduces the time to report both identification and AST. Thus, following blood culture positivity, identification by MALDI-TOF can be reported within less than 1 hr whereas results of AST by automated AST systems or disc diffusion assays within 8 to 18 hr, respectively. Similarly, the results of a rapid PCR-based assay can be communicated to the clinicians less than 2 hr following the report of a bacteremia. Together, these results demonstrate that the rapid preparation of a blood culture bacterial pellet has a significant impact on the identification and AST turnaround time and thus on the successful outcome of patients suffering from bloodstream infections.

Development of new dissolution test and HPLC-RP method for anti-parasitic ornidazole coated tablets

This work aimed the development and validation of a new dissolution test for ornidazole coated tablets. The dissolution conditions were determined after testing Sink conditions, dissolution medium, apparatus, stirring speed, 24 h stability and medium filtration influence. The best conditions were paddle at a stirring speed of 75 rpm and 900 mL of 0.1 M HCl. A new HPLC quantification method was developed and validated. The dissolution test and quantification method showed to be adequate for their purposes and could be applied for quality control of ornidazole coated tablets, since there is no official monograph.

Nanoparticle-Assisted Immunoassays for Point-of-Care Testing - With Specific Interest in Minimally Interference-Prone Assays for Cardiac Troponin I

Cardiac troponins (cTn) I and T are the current golden standard biochemical markers in the diagnosis and risk stratification of patients with suspected acute coronary syndrome. During the past few years, novel assays capable of detecting cTn‐concentrations in >50% of apparently healthy individuals have become readily available. With the emerging of these high sensitivity cTn assays, reductions in the assay specificity have caused elevations in the measured cTn levels that do not correlate with the clinical picture of the patient. The increased assay sensitivity may reveal that various analytical interference mechanisms exist. This doctoral thesis focused on developing nanoparticle‐assisted immunometric assays that could possibly be applied to an automated point‐of‐care system. The main objective was to develop minimally interference‐prone assays for cTnI by employing recombinant antibody fragments. Fast 5‐ and 15‐minute assays for cTnI and D‐dimer, a degradation product of fibrin, based on intrinsically fluorescent nanoparticles were introduced, thus highlighting the versatility of nanoparticles as universally applicable labels. The utilization of antibody fragments in different versions of the developed cTnI‐assay enabled decreases in the used antibody amounts without sacrificing assay sensitivity. In addition, the utilization of recombinant antibody fragments was shown to significantly decrease the measured cTnI concentrations in an apparently healthy population, as well as in samples containing known amounts of potentially interfering factors: triglycerides, bilirubin, rheumatoid factors, or human anti‐mouse antibodies. When determining the specificity of four commercially available antibodies for cTnI, two out of the four cross‐reacted with skeletal troponin I, but caused crossreactivity issues in patient samples only when paired together. In conclusion, the results of this thesis emphasize the importance of careful antibody selection when developing cTnI assays. The results with different recombinant antibody fragments suggest that the utilization of antibody fragments should strongly be encouraged in the immunoassay field, especially with analytes such as cTnI that require highly sensitive assay approaches.

Spectrally Tuned Lanthanide Photoluminescence for Point-of-Care Testing

Point-of-care (POC) –diagnostics is a field with rapidly growing market share. As these applications become more widely used, there is an increasing pressure to improve their performance to match the one of a central laboratory tests. Lanthanide luminescence has been widely utilized in diagnostics because of the numerous advantages gained by the utilization of time-resolved or anti-Stokes detection. So far the use of lanthanide labels in POC has been scarce due to limitations set by the instrumentation required for their detection and the shortcomings, e.g. low brightness, of these labels. Along with the advances in the research of lanthanide luminescence, and in the field of semiconductors, these materials are becoming a feasible alternative for the signal generation also in the future POC assays. The aim of this thesis was to explore ways of utilizing time-resolved detection or anti-Stokes detection in POC applications. The long-lived fluorescence for the time-resolved measurement can be produced with lanthanide chelates. The ultraviolet (UV) excitation required by these chelates is cumbersome to produce with POC compatible fluorescence readers. In this thesis the use of a novel light-harvesting ligand was studied. This molecule can be used to excite Eu(III)-ions at wavelengths extending up to visible part of the spectrum. An enhancement solution based on this ligand showed a good performance in a proof-of-concept -bioaffinity assay and produced a bright signal upon 365 nm excitation thanks to the high molar absorptivity of the chelate. These features are crucial when developing miniaturized readers for the time-resolved detection of fluorescence. Upconverting phosphors (UCPs) were studied as an internal light source in glucose-sensing dry chemistry test strips and ways of utilizing their various emission wavelengths and near-infrared excitation were explored. The use of nanosized NaYF :Yb3+,Tm3+-particles enabled the replacement of an external UV-light source with a NIR-laser and gave an additional degree of freedom in the optical setup of the detector instrument. The new method enabled a blood glucose measurement with results comparable to a current standard method of measuring reflectance. Microsized visible emitting UCPs were used in a similar manner, but with a broad absorbing indicator compound filtering the excitation and emission wavelengths of the UCP. This approach resulted in a novel way of benefitting from the non-linear relationship between the excitation power and emission intensity of the UCPs, and enabled the amplification of the signal response from the indicator dye.

Anti-quorum sensing activity of phenolic extract from Eugenia brasiliensis (Brazilian cherry)

Abstract The aim of this study was to assess the anti-quorum sensing activity of phenolic extracts from grumixama (Eugenia brasiliensis), also known as Brazilian cherry, in concentrations that did not interfere with bacterial growth. The pulp phenolic compounds were extracted by using solid phage extraction in a mini-collumn C18 and quantified by spectrophotometry. The anti-quorum sensing activity was evaluated by testing the inhibition of violacein production in Chromobacterium violaceum and by evaluating the swarming motility in Aeromonas hydrophila and Serratia marcescens, both phenotypes regulated by quorum sensing. The phenolic extract strongly inhibited the production of violacein in C. violaceum, reducing its production in comparison with a control with no extract. No inhibition of growth was observed at the concentrations tested for quorum sensing inhibition. Confirming the quorum sensing inhibition phenotype, the extract was also able to inhibit swarming motility in S. marcescens and in A. hydrophila, although in the later the effect was marginal. Overall, these results indicate that phenolic extract from E. brasiliensis presents quorum sensing inhibitory activity most likely due to the presence of fruit phenolics which have been implicated as quorum sensing inhibitors in Gram negative bacteria.

Prolongation de l’intervalle QT corrigé chez les adultes atteints de lupus érythémateux disséminé porteurs de l’anticorps anti-Ro/SSA

La prolongation de l’intervalle électrocardiographique QT est un facteur de risque d’arythmie ventriculaire et de mort subite. Cette anomalie, retrouvée chez certains patients atteints de lupus érythémateux disséminé, pourrait contribuer à la mortalité cardiovasculaire élevée dans cette population. L’anti-Ro/SSA, un auto-anticorps retrouvé chez environ 30% des patients atteints de lupus, est associé à la présence de blocs cardiaques chez le nouveau-né et pourrait aussi augmenter le risque de prolongation pathologique de l’intervalle QT chez l’adulte. Le présent mémoire est constitué de cinq chapitres traitant de l’association potentielle entre l’anticorps anti-Ro/SSA et la prolongation de l’intervalle QT. Le premier chapitre constitue une introduction permettant de mettre en contexte les éléments essentiels à la compréhension du projet d’étude. Le deuxième chapitre constitue une revue de l’état des connaissances actuelles sur le lien potentiel entre anti-Ro/SSA et intervalle QT. Le troisième chapitre présente le projet d’étude par l’intermédiaire d’un article publié dans Arthritis Care and Research. Dans cette étude, les patients de la cohorte de lupiques du Centre Universitaire de santé McGill ont subi des électrocardiogrammes dans l’objectif d’estimer l’association entre l’anti-Ro/SSA et les anomalies électrocardiographiques, en tenant compte d’autres facteurs démographiques et cliniques. L’association entre la prolongation de l’intervalle QT et la présence de l’anti-Ro/SSA a été démontrée (rapports de cotes ajustés de 5.1 à 12.6) et les patients porteurs de l’anti-Ro/SSA pourraient donc bénéficier de dépistage électrocardiographique systématique. Les points faibles et forts de cet article sont discutés dans le quatrième chapitre et des perspectives de recherches futures sont finalement abordées.

Political Education in Plural Societies: Using the Anti-Bias Approach to Challenge Oppression in Bombay and Berlin

This study addresses the effectivity of the Anti-Bias approach and training methodology as a pedagogical political strategy to challenge oppression among student groups in the cities of Bombay and Berlin. The Anti-Bias trainings conducted within the framework of this study also become the medium through which the perpetuation of oppressive structures by students within and outside the school is investigated. Empirical data from predominantly qualitative investigations in four secondary schools, two each in Bombay and Berlin, is studied and analysed on the basis of theoretical understandings of prejudice, discrimination and identity. This study builds on insights offered by previous research on prejudices and evaluations of anti-bias and diversity interventions, where the lack of sufficient research and thorough evaluations testing impact has been identified (Levy Paluck, 2006). The theoretical framework suggests that prejudices and discriminatory practices are learnt and performed by individuals over the years by way of pre-existing discourses, and that behaviour and practices can be unlearnt through a multi-step process. It proposes that the discursive practices of students contribute to the constitution of their viable selves and in the constitution of ‘others’. Drawing on this framework, the study demonstrates how student-subjects in Bombay and Berlin perpetuate oppressive discourses by performing their identities and performing identities onto ‘others’. Such performative constitution opens up the agency of the individual, disclosing the shifting and dynamic nature of identities. The Anti-Bias approach is posited as an alternative to oppressive discourses and a vehicle that encourages and assists the agency of individuals. The theoretical framework, which brings together a psychological approach to prejudice, a structural approach to discrimination and a poststructural approach to identity, facilitates the analysis of the perpetuation of dominant discourses by the students, as well as how they negotiate their way through familiar norms and discourses. Group discussions and interviews a year after the respective trainings serve to evaluate the agency of the students and the extent to which the training impacted on their perceptions, attitudes and behavioural practices. The study reveals the recurrence of the themes race, religion, gender and sexuality in the representational practices of the students groups in Berlin and Bombay. It demonstrates how students in this study not only perform, but also negotiate and resist oppressive structures. Of particular importance is the role of the school: When schools offer no spaces for discussion, debate and action on contemporary social issues, learning can neither be put into practice nor take on a positive, transformative form. In such cases, agency and resistance is limited and interventionist actions yield little. This study reports the potential of the Anti-Bias approach and training as a tool of political education and action in education. It demonstrates that a single training can initiate change but sustaining change requires long-term strategies and on-going actions. Taking a poststructural perspective, it makes concrete suggestions to adapt and alter the Anti-Bias approach and the implementation of Anti-Bias trainings.

Occurrence of anti-Neospora caninum and anti-Toxoplasma gondii IgG antibodies in goats and sheep in western Maranhão, Brazil

A neosporose e a toxoplasmose são doenças parasitárias que podem causar problemas reprodutivos em caprinos e ovinos. O objetivo deste estudo foi determinar a ocorrência de anticorpos IgG anti-Neospora caninum e anti-Toxoplasma gondii em caprinos e ovinos dos municípios de Amarante do Maranhão e Buritirana, microrregião de Imperatriz, Oeste maranhense, Nordeste do Brasil, bem como avaliar fatores associados à infecção por esses agentes etiológicos. Amostras de sangue de 110 animais (46 caprinos e 64 ovinos), provenientes de cinco propriedades, foram coletadas, e a reação de imunofluorescência indireta utilizada para o diagnóstico sorológico. Das 46 amostras de caprinos, 17,39% (n = 8) apresentaram anticorpos anti-N. caninum e 4,35% (n = 2) anti-T. gondii, enquanto das 64 amostras de ovinos, 4,69% (n = 3) e 18,75% (n = 12) apresentaram anticorpos anti-N. caninum e anti-T. gondii, respectivamente. Não houve diferença significativa, considerando-se a presença de gato e/ou cão na propriedade e assistência veterinária para ambos os agentes estudados. Entretanto, suplementação alimentar e presença de animais com problemas reprodutivos diferiram significativamente (p < 0,05) em ovinos e caprinos, respectivamente. Os resultados do presente estudo demonstraram que caprinos e ovinos, da região Oeste do Maranhão são expostos aos coccídios N. caninum e T. gondii. Essa é a primeira evidência desses agentes em pequenos ruminantes nessa região.

Road segment delineation using active testing principle and an edge-based post-processing strategy

This paper presents a semi-automated method for extracting road segments from medium-resolution images based on active testing and edge analysis. The method is based on two sequential and independent stages. Firstly, an active testing method is used to extract an approximated road centreline which is based on a sequential and local exploitation of the image. Secondly, an iterative strategy based on edge analysis and the approximated centreline is used to measure precisely the road centreline. Based on the results obtained using medium-resolution test images, the method seems to be very promising. In general, the method proved to be very accurate whenever the roads are characterized by two well-defined anti-parallel edges and robust even in the presence of larger obstacles such as trees and shadows.

Anti-inflammatory and analgesic evaluation of hydroalcoholic extract and fractions from seeds of Piper cubeba L. (Piperaceae)

Some of the Piper species have been applied for the treatment of several diseases (anti-oxidant, antimicrobial, anti-inflammatory, and analgesic), considering multiple applications used in traditional medicine of different countries. About these, the present study evaluated some biological activities of Piper cubeba, as writhing test induced by acetic acid, ear edema induced by croton oil and paw edema induced by carrageenan were used by evaluated the analgesic and anti-inflammatory activities of crude hydroalcoholic extract (PCE) and its fractions of different polarities of P. cubeba L. seeds. The lethal dose (LD50) and the effective dose (ED50) were evaluated too. Both the PCE and dichloromethane fraction showed decrease values of edema and abdominal constrictions. The results obtained in this study confirm the low toxicity and analgesic and anti-inflammatory activities of PCE from P. cubeba seeds, justifying its use in folk medicine. Copyright © 2013, Phcog.Net, Published by Reed Elsevier India Pvt. Ltd. All rights reserved.

Atividade física e lipodistrofia em portadores de HIV/AIDS submetidos à terapia anti-retroviral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Determinação do perfil pré-clínico da atividade anti-tuberculose in vitro e in vivo de complexos heterolépticos de Rutênio(II) com fosfinas. diiminas e picolinato como ligantes

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)