Médicaments chez les seniors vaudois à domicile : nombre et composition

La question de la pertinence et de la sécurité des traitements médicamenteux dans la population âgée prend toujours plus d'importance dans nos sociétés en raison de l'accroissement en nombre des personnes âgées et de l'expansion continuelle des possibilités thérapeutiques. La nécessité d'individualiser et de rationnaliser la prescription chez le sujet âgé est universellement reconnue. Par ailleurs, il est bien documenté que le fait de prendre un nombre élevé de médicaments différents accroît le risque d'effets indésirables, de défaut d'adhérence et de difficultés de gestion des traitements. La présente étude explore les traitements médicamenteux des seniors vaudois et formule des propositions visant une «polymédication rationnelle». Une enquête conduite en 2012 dans le canton de Vaud auprès de 3'133 personnes âgées de 69 ans et plus vivant en domicile privé comportait une section sur le traitement médicamenteux actuel des répondants (autodéclaration, questionnaire rempli à domicile). Les réponses à cette question sont analysées dans l'objectif de décrire la consommation de médicaments en termes quantitatifs (notamment mesurer la prévalence de la polymédication), ainsi que la relation entre polymédication et certains facteurs d'influence, et la composition des traitements.

A conceptual model for grid learning services automatic composition

Peer-reviewed

Human Capital Composition and Economic Growth at a Regional Level

With this paper we build a two-region model where both innovation and imitation are performed. In particular imitation takes the form of technological spillovers that lagging regions may exploit given certain human capital conditions. We show how the high skill content of each region’s workforce (rather than the average human capital stock) is crucial to determine convergence towards the income level of the leader region and to exploit the technological spillovers coming from the frontier. The same applies to bureaucratic/institutional quality which are conductive to higher growth in the long run. We test successfully our theoretical result over Spanish regions for the period between 1960 and 1997. We exploit system GMM estimators which allow us to correctly deal with endogeneity problems and small sample bias.

Appropriate IPRs, Human Capital Composition and Economic Growth

We generalize a standard technology diffusion model by allowing for IPRs regimes to be endogenously defined by the development level of each country. Also we insert differences in the composition of human capital between North (leader) and South (followers) which shape the relative costs of innovation and imitation. Results show how an optimal growth trajectory is found for the follower country which initially imitates and that, once a "threshold development stage" is reached, optimally switches to innovation by fully enforcing IPRs achieving a higher proximity with the technology frontier in the long-run. Other scenarios, such as a premature increase in the enforcement of IPRs or a switch from imitation to innovation at early stages of development of the followers are found to be sub-optimal.

Different Plasma Markers of Inflammation Are Influenced by Immune Recovery and cART Composition or Intensification in Treated HIV Infected Individuals

Abstract Background HIV-1 infection increases plasma levels of inflammatory markers. Combination antiretroviral therapy (cART) does not restore inflammatory markers to normal levels. Since intensification of cART with raltegravir reduced CD8 T-cell activation in the Discor-Ral and IntegRal studies, we have evaluated the effect of raltegravir intensification on several soluble inflammation markers in these studies. Methods Longitudinal plasma samples (0–48 weeks) from the IntegRal (n = 67, 22 control and 45 intensified individuals) and the Discor-Ral studies (44 individuals with CD4 T-cell counts<350 cells/µl, 14 control and 30 intensified) were assayed for 25 markers. Mann-Whitney, Wilcoxon, Spearman test and linear mixed models were used for analysis. Results At baseline, different inflammatory markers were strongly associated with HCV co-infection, lower CD4 counts and with cART regimens (being higher in PI-treated individuals), but poorly correlated with detection of markers of residual viral replication. Although raltegravir intensification reduced inflammation in individuals with lower CD4 T-cell counts, no effect of intensification was observed on plasma markers of inflammation in a global analysis. An association was found, however, between reductions in immune activation and plasma levels of the coagulation marker D-dimer, which exclusively decreased in intensified patients on protease inhibitor (PI)-based cART regimens (P = 0.040). Conclusions The inflammatory profile in treated HIV-infected individuals showed a complex association with HCV co-infection, the levels of CD4 T cells and the cART regimen. Raltegravir intensification specifically reduced D-dimer levels in PI-treated patients, highlighting the link between cART composition and residual viral replication; however, raltegravir had little effect on other inflammatory markers.

Effect of diet composition and ration size on key enzyme activities of glycolysis-gluconeogenesis, pentose phosphate pathway and amino acid metabolism in liver of Sparus aurata

The effects of diet composition and ration size on the activities of key enzymes involved in intermediary metabolism were studied in the liver of gilthead sea bream (Sparus aurata). Highcarbohydrate, low-protein diets stimulated 6-phosphofructo 1-kinase (EC 2.7.1.11), pyruvate kinase (EC 2.7.1.40), glucose-6-phosphate dehydrogenase (EC 1.1.1.49) and 6-phosphogluconate dehydrogenase (EC 1.1.1.44) enzyme activities, while they decreased alanine aminotransferase (EC 2.6.1.2) activity. A high degree of correlation was found between food ration size and the activity of the enzymes 6-phosphofructo 1-kinase, pyruvate kinase, glucose-6-phosphate dehydrogenase (positive correlations) and fructose-1,6-bisphosphatase (EC 3.1.3.11) (negative correlation). These correlations matched well with the high correlation also found between ration size and growth rate in starved fish refed for 22 d. Limited feeding (5 g/kg body weight) for 22 d decreased the activities of the key enzymes for glycolysis and lipogenesis, and alanine aminotransferase activity. The findings presented here indicate a high level of metabolic adaptation to both diet type and ration size. In particular, adaptation of enzyme activities to the consumption of a diet with a high carbohydrate level suggests that a carnivorous fish like Sparus aurata can tolerate partial replacement of protein by carbohydrate in the commercial diets supplied in culture. The relationship between enzyme activities, ration size and fish growth indicates that the enzymes quickly respond to dietary manipulations of cultured fish.

Effect of diet composition and ration size on key enzyme activities of glycolysis-gluconeogenesis, pentose phosphate pathway and amino acid metabolism in liver of Sparus aurata

The effects of diet composition and ration size on the activities of key enzymes involved in intermediary metabolism were studied in the liver of gilthead sea bream (Sparus aurata). Highcarbohydrate, low-protein diets stimulated 6-phosphofructo 1-kinase (EC 2.7.1.11), pyruvate kinase (EC 2.7.1.40), glucose-6-phosphate dehydrogenase (EC 1.1.1.49) and 6-phosphogluconate dehydrogenase (EC 1.1.1.44) enzyme activities, while they decreased alanine aminotransferase (EC 2.6.1.2) activity. A high degree of correlation was found between food ration size and the activity of the enzymes 6-phosphofructo 1-kinase, pyruvate kinase, glucose-6-phosphate dehydrogenase (positive correlations) and fructose-1,6-bisphosphatase (EC 3.1.3.11) (negative correlation). These correlations matched well with the high correlation also found between ration size and growth rate in starved fish refed for 22 d. Limited feeding (5 g/kg body weight) for 22 d decreased the activities of the key enzymes for glycolysis and lipogenesis, and alanine aminotransferase activity. The findings presented here indicate a high level of metabolic adaptation to both diet type and ration size. In particular, adaptation of enzyme activities to the consumption of a diet with a high carbohydrate level suggests that a carnivorous fish like Sparus aurata can tolerate partial replacement of protein by carbohydrate in the commercial diets supplied in culture. The relationship between enzyme activities, ration size and fish growth indicates that the enzymes quickly respond to dietary manipulations of cultured fish.

Composition and antifungal activity of essential oils from Piper aduncum, Piper arboreum and Piper tuberculatum

The composition of essential oils from leaves, stems and fruits of Piper aduncum, P. arboreum and P. tuberculatum was examined by means of GC-MS and antifungal assay. There was a predominance of monoterpenes in P. aduncum and P. tuberculatum and of sesquiterpenes in P. arboreum. P. aduncum showed the richest essential oil composition, including linalool. The essential oils from fruits of P. aduncum and P. tuberculatum showed the highest antifungal activity with the MIC of 10 µg as determined against Cladosporium cladosporioides and C. sphaerospermum, respectively. This is the first report of the composition of essential oils from P. tuberculatum.

Chemical composition of umbu (Spondias tuberosa Arr. Cam) seeds

The umbu tree (Spondias tuberosa Arr. Cam) is an important fruit tree the economy of the semi-arid northeastern region of Brazil. With the objective of finding use for the seeds, physical and chemical characterizations of the seeds from 2 cultivars in 2 maturation stages were carried out and their fatty acid and mineral profiles determined. The results showed no differences between the seeds analyzed. The yield was about 10% and the dimensions as follows: length from 1.48 to 2.11 cm and width from 0.76 to 1.16 cm. The average lipid content was 55% of which 69% was unsaturated and the average protein content was 24%. The seeds were a good source of the following minerals: P, K, Mg, Fe and Cu. The overall results indicated that the oil or the seeds could be used for food stuffs if no toxic agents were found.

Evaluation of seasonal changes in chemical composition and antibacterial activity of Elyonurus muticus (sprengel) O. Kuntze (Gramineae)

Aerial parts of Elyonurus muticus were collected in the four seasons of the year in the Brazilian Pantanal and subjected to extractrion with cold ethanol and to hydrodistillation. Sesquiterpenoids (E)-caryophyllene, bicyclogermacrene, spathulenol and caryophyllene oxide were the main components identified in the essential oils and their concentrations varied according to the plant collection period. The essential oils and the ethanolic crude extracts were active against Bacillus cereus MIP 96016, Pseudomonas aeruginosa ATCC 27853 and Staphylococcus aureus ATCC 25923 and were not active against Escherichia coli ATCC 25922. The antibacterial activities varied according to the plant collection period.

Decomposição térmica de espumas de poliuretano para fabricação de vitrocerâmica celular de Li2O-ZrO2-SiO2-Al2O3 (LZSA)

Characterization of the thermal decomposition of polyurethane (PUR) foams was performed by Fourier-transformed infrared (FT-IR) spectroscopy and thermogravimetric analysis (TGA). Three main weight loss paths were observed by TGA, the residue being lower than 3 wt.% for 3 different PUR foams analyzed. FT-IR spectra indicated CO2, CO, NH3 and isocyanides as main decomposition products. PUR foams of different cell sizes were immersed in a slurry of the parent glass ceramic of composition Li2O-ZrO2-SiO2-Al 2O3 (LZSA) and submitted to heat treatment. The LZSA cellular glass ceramics obtained after sintering and crystallization resembled the original morphology of the PUR foams.

Physicochemical composition of Apis mellifera honey samples from São Paulo State, Brazil

This research, developed with Apis mellifera honey samples from producers of São Paulo State, Brazil, has the objective of verifying how eucalyptus, wild flower, and orange honey samples would be clustered, based on physicochemical characteristics. All the orange honey samples and some wild flower ones formed distinct groups, thus confirming that the floral source interferes with honey characteristics. Eucalyptus and some of the wild flower honey samples were clustered together because of the great floral source variation in the latter ones. The characteristics that influence sample clustering are acidity and electric conductivity on the X axis, and total sugars and pH on the Y axis.

Chemical composition and antimicrobial activity of the essential oil from Aeolanthus suaveolens Mart. ex Spreng

The essential oils from leaves (sample A) and flowers (sample B) of Aeolanthus suaveolens Mart. ex Spreng were obtained by hydrodistillation and analyzed by GC, GC-MS, and chiral phase gas chromatography (CPGC). Six compounds have been identified from the essential oils, representing ca 94.3 and 93% of the oils corresponding to samples A and B, respectively. The major constituents of samples A and B essential oils were respectively, linalool (34.2%/34.9%), (-)-massoialactone (25.9%/17.0%) and (E)-beta-farnesene (25.4%/29.1%). The enantiomeric distribution of the monoterpene linalool was established by analysis on heptakis- (6-O-methyl-2,3-di-O-pentyl)-beta-cyclodextrin capillary column. The antimicrobial activity of the essential oil from leaves and isolated compounds was also evaluated.

Seasonal variation in the composition of volatile oils from Schinus terebinthifolius raddi

Essential oils from leaves, ripe and unripe fruits of Schinus terebinthifolius growing in Brazil were investigated. Oil content from either ripe or unripe fruits was similar (4.65% and 3.98%, respectively). Sesquiterpenes (from 78.0% to 90.4%) dominated the oil content of both leaves and unripe fruit. The essential oils were tested in vitro for their allelopathic activity on germination and radicle growth of Lactuca sativa and Cucumis sativus at 1,000 and 10,000 µg mL-1concentrations. The three samples tested were more active in inhibiting the radicle growth for L. sativa (88.6-92.4%) than for C. sativus (50.5-84.5%) at 10,000 µg mL-1 concentration.