Étude des biais sur la dose parentérale d'un nouveau médicament lors d'un essai clinique avec profil cinétique

Introduction et objectif: Lors d'essais cliniques, le pharmacien est responsable de la préparation et de la dispensation des médicaments à évaluer. Un article récent a toutefois montré que les aspects pharmaceutiques liés au contrôle de la dose administrée in fine étaient souvent mal contrôlés. Il peut exister une différence entre la dose nominale fournie par le certificat d'analyse du fabricant et la dose réellement administrée au sujet, biais qui se reporte en cascade sur l'estimation des paramètres pharmacocinétiques (PK), comme la clairance ou le volume de distribution. Ce travail visait à évaluer les biais entachant la quantité de médicament réellement injectée (iv/sc) aux volontaires d'un essai clinique étudiant la PK et la relation dose-réponse d'un nouveau produit biotechnologique. Méthode: La dose de médicament administrée lors de l'essai clinique (D) a été calculée de la manière suivante: D = C * V - pertes. La concentration du produit (C; titre nominal du fabricant) a été vérifiée par immuno-essai. Le volume de médicament injecté (V) a été déterminé pour chaque injection par pesée (n=72), en utilisant la masse de la seringue avant et après injection et la densité du produit. Enfin, une analyse in vitro a permis d'évaluer les pertes liées à l'adsorption du produit dans les lignes de perfusion et de choisir le dispositif adéquat in vivo. Résultats: La concentration du médicament s'est révélée proche du titre nominal (96 ± 7%), et a été utilisée comme référence. Le volume injecté était quant à lui entaché d'un biais systématique par rapport à la valeur théorique correspondant à 0.03 mL pour la dose minimale (i.e. 75% du volume à injecter à cette dose). Une analyse complémentaire a montré que cela s'expliquait par une réaspiration partielle de la solution médica-menteuse avant le retrait de la seringue après injection sc, due à l'élasticité du piston. En iv, le biais était par contre provoqué par une réaspiration du soluté de perfusion co-administré. Enfin, la mesure des quantités de médicament récupérées après injection dans le dispositif de perfusion a démontré des pertes minimales par adsorption. Discussion-conclusion: Cette étude confirme l'existence de biais inversement corrélés au volume et à la concentration du médicament administré, pouvant provoquer des erreurs importantes sur les paramètres PK. Ce problème est négligé ou insuffisamment considéré dans les protocoles de Phase I et nécessiterait une planification rigoureuse. Les procédures opératoires devraient attirer l'attention sur ce point crucial.

The complete genome sequence of the gram-positive bacterium Bacillus subtilis.

Bacillus subtilis is the best-characterized member of the Gram-positive bacteria. Its genome of 4,214,810 base pairs comprises 4,100 protein-coding genes. Of these protein-coding genes, 53% are represented once, while a quarter of the genome corresponds to several gene families that have been greatly expanded by gene duplication, the largest family containing 77 putative ATP-binding transport proteins. In addition, a large proportion of the genetic capacity is devoted to the utilization of a variety of carbon sources, including many plant-derived molecules. The identification of five signal peptidase genes, as well as several genes for components of the secretion apparatus, is important given the capacity of Bacillus strains to secrete large amounts of industrially important enzymes. Many of the genes are involved in the synthesis of secondary metabolites, including antibiotics, that are more typically associated with Streptomyces species. The genome contains at least ten prophages or remnants of prophages, indicating that bacteriophage infection has played an important evolutionary role in horizontal gene transfer, in particular in the propagation of bacterial pathogenesis.

Adubação com potássio e nitrogênio em três cíclos de produção da bananeira cv. prata-anã

O nitrogênio, depois do potássio, é o elemento mais exigido pela bananeira. O desbalanço entre N e K afeta a produção e a qualidade do fruto de banana. O objetivo deste trabalho foi avaliar a influência das adubações com nitrogênio e potássio na produção da bananeira c.v. Prata-Anã (grupo genômico AAB). O experimento foi realizado em Latossolo Vermelho-Amarelo na região do Semi-árido do Norte de Minas Gerais e irrigado por microaspersão. Estudaram-se cinco doses de N (0; 200; 400; 800 e 1600 kg ha-1ano-1) e cinco doses de K2O (0; 200; 400; 800 e 1600 kg ha-1ano-1), em esquema fatorial (5x5), durante o 2º, 3º e 4º ciclos de produção. A aplicação de doses crescentes de N elevou o teor de Mn nas folhas acima da faixa adequada, promovendo queda na produção de banana no 2º e 3º ciclos. Portanto, infere-se que o teor de Mn nas folhas atingiu nível tóxico. Houve efeito do K sobre a produção de banana apenas no 4º ciclo. A produção máxima de banana no 4º ciclo foi obtida com a aplicação de 962,5 kg de K2O ha-1ano-1. Não ocorreu interação significativa entre N e K.

Unplanned complex suicide by self-strangulation associated with multiple sharp force injuries: a case report.

In cases of ligature strangulation, the importance of distinguishing self-inflicted death from homicide is crucial. This entails objective scene investigation, autopsy and anamnesis in order to elucidate the manner of death correctly. The authors report a case of unplanned complex suicide by means of self-strangulation and multiple sharp force injury. The use of more than one suicide method, consecutively--termed unplanned complex suicide--gives this case particular significance. A brief discussion on this uncommon method of suicide is presented, particularly relevant to the attending forensic physician. In addition, a short overview of the entity of complex suicide is given.

Wollastoniittimarkkinat ja suomalaisen tuottajan asemoituminen markkinoilla

Työn tarkoituksena oli tehdä yleiskuvaus wollastoniittimarkkinoista, ja siten auttaa yritystä sisäisesti määrittämään asemansa kyseisillä markkinoillaWollastoniitin suurimmat kuluttajasektorit ovat keraaminen-, muovi-, maali- ja pinnoite-, sekä metallurginen teollisuus. Eniten mineraalin kulutuksen odotetaan kasvavan muoviteollisuudessa. Suurimmat wollastoniitin tuottajamaat ovat Kiina, Intia, Yhdysvallat, Meksiko ja Suomi. Kiinassa aktiivisia kaivoksia on tällä hetkellä noin 60 kappaletta, ja koko maan tuotanto kattaa noin puolet mineraalin kokonaistuotannosta. Kiinan ulkopuolella toimii yhteensä viisi suurta tuottajaa.Suurimmat wollastoniitin tuottajat ovat intialainen Wolkem India Ltd., kiinalaiset Dalian Huanqui Minerals Corp. ja Jilin Shanwei Wollastonite Mining Co. Ltd, yhdysvaltalaiset Nyco Minerals Inc. ja R.T. Vanderbilt Co., meksikolainen Nyco Minera S.A. de C.V. ja suomalainen Nordkalk Oyj Abp. Uusia tuotantolaitoksia suunnitellaan rakennettavaksi Venäjälle, Kanadaan ja Kazakstaniin.

Theta-duality on Prym varieties and a Torelli Theorem

Let $\pi : \widetilde C \to C$ be an unramified double covering of irreducible smooth curves and let $P$ be the attached Prym variety. We prove the scheme-theoretic theta-dual equalities in the Prym variety $T(\widetilde C)=V^2$ and $T(V^2)=\widetilde C$, where $V^2$ is the Brill-Noether locus of $P$ associated to $\pi$ considered by Welters. As an application we prove a Torelli theorem analogous to the fact that the symmetric product $D^{(g)}$ of a curve $D$ of genus $g$ determines the curve.

PTX3 Polymorphisms and Invasive Mold Infections After Solid Organ Transplant.

Donor PTX3 polymorphisms were shown to influence the risk of invasive aspergillosis among hematopoietic stem cell transplant recipients. Here, we show that PTX3 polymorphisms are independent risk factors for invasive mold infections among 1101 solid organ transplant recipients, thereby strengthening their role in mold infection pathogenesis and patients' risk stratification.

Comprehensive Genomic Characterization of Long Non-coding RNAs across Human Cancers.

The discovery of long non-coding RNA (lncRNA) has dramatically altered our understanding of cancer. Here, we describe a comprehensive analysis of lncRNA alterations at transcriptional, genomic, and epigenetic levels in 5,037 human tumor specimens across 13 cancer types from The Cancer Genome Atlas. Our results suggest that the expression and dysregulation of lncRNAs are highly cancer type specific compared with protein-coding genes. Using the integrative data generated by this analysis, we present a clinically guided small interfering RNA screening strategy and a co-expression analysis approach to identify cancer driver lncRNAs and predict their functions. This provides a resource for investigating lncRNAs in cancer and lays the groundwork for the development of new diagnostics and treatments.

Belgian experience with triple therapy with boceprevir and telaprevir in genotype 1 infected patients who inject drugs.

No data have been reported yet on treatment outcome in persons who inject drugs (PWID) infected with hepatitis C virus treated with boceprevir or telaprevir in combination with peginterferon (Peg IFN) and ribavirin (RBV). Additionally, there are concerns about the safety of boceprevir and telaprevir in some subgroups of patients with hepatitis C (HCV). In a cohort of HCV patients infected with genotype 1 in Belgium, treatment outcome of patients infected due to IV drug use was analyzed and compared with patients who have no history of substance use. The study population consisted of 179 patients: 78 PWID and 101 controls treated with boceprevir (n = 79) or telaprevir (n = 100) additional to Peg IFN and RBV; 53 (30%) had advanced disease (F3, F4) and 79 (44%) had an antiviral therapy previously. There were no significant differences in the baseline characteristics between both groups, except that PWID patients were more frequently infected with genotype 1a (67% vs 21%), were younger and were predominantly male. Psychiatric complaints during follow-up occurred more frequently in the PWID patients: 24% versus 11% (P = .02). Treatment failure for other reasons than absence of viral response was 70% and 64% in PWID and non-PWID respectively. The sustained viral response (SVR) rates were similar in both groups (71% in PWID vs 72% in non-PWID); with a non-inferiority test with -5% margin there is a difference of -1% (95% CI [-15%, 13%]) and P = 0.30. There are no reasons to exclude PWID from treatment with boceprevir, telaprevir and novel antiviral therapies. J. Med. Virol. 88:94-99, 2016. © 2015 Wiley Periodicals, Inc.

Metabolic and nutritional support of critically ill patients: consensus and controversies.

The results of recent large-scale clinical trials have led us to review our understanding of the metabolic response to stress and the most appropriate means of managing nutrition in critically ill patients. This review presents an update in this field, identifying and discussing a number of areas for which consensus has been reached and others where controversy remains and presenting areas for future research. We discuss optimal calorie and protein intake, the incidence and management of re-feeding syndrome, the role of gastric residual volume monitoring, the place of supplemental parenteral nutrition when enteral feeding is deemed insufficient, the role of indirect calorimetry, and potential indications for several pharmaconutrients.

Targeted cell elimination reveals an auxin-guided biphasic mode of lateral root initiation.

To sustain a lifelong ability to initiate organs, plants retain pools of undifferentiated cells with a preserved proliferation capacity. The root pericycle represents a unique tissue with conditional meristematic activity, and its tight control determines initiation of lateral organs. Here we show that the meristematic activity of the pericycle is constrained by the interaction with the adjacent endodermis. Release of these restraints by elimination of endodermal cells by single-cell ablation triggers the pericycle to re-enter the cell cycle. We found that endodermis removal substitutes for the phytohormone auxin-dependent initiation of the pericycle meristematic activity. However, auxin is indispensable to steer the cell division plane orientation of new organ-defining divisions. We propose a dual, spatiotemporally distinct role for auxin during lateral root initiation. In the endodermis, auxin releases constraints arising from cell-to-cell interactions that compromise the pericycle meristematic activity, whereas, in the pericycle, auxin defines the orientation of the cell division plane to initiate lateral roots.

Uma demonstração simples e visual do efeito do aquecimento com microondas em reações de poliadição

Polyaddition of commercial monomers is easily performed on a domestic microwave oven. The rate of polymerization depends on the structure of the monomer, power and time of irradiation. This methodology can easily be used to demonstrate the acceleration of organic reactions promoted by microwaves.

Taidehistoria

Taidehistorian pääkokoelma sijaitsee kirjaston lainattavassa kokoelmassa. Se koostuu n. 3 400 niteestä monografioita (tiedot marraskuulta 2009). Lisäksi on noin 100 jatkuvaa painettua julkaisua, n. 100 elektronista lehteä ja vanhoja foliokokoisia taidekirjoja noin 8 hm. Taidehistoria ei ole kirjaston ydinaihealue, ja kokoelmaa ei kartuteta aktiivisesti muuten kuin kotimaisen ja pohjoismaisen vanhan taiteen tutkimuksen osalta. Kokoelma on koostunut pääasiassa lahjoituksista. Nykytaidetta ei juurikaan oteta kokoelmiin. Kokoelma on tästä syystä huomattavan vanhaa, 34 % on julkaistu ennen vuotta 1950 (pohjoismaiden ja muiden maiden luokissa 42 %). 2000-luvulla julkaistua aineistoa on koko taidehistorian kokoelmassa vain 7 %. Suomen taidehistoriaa kartutetaan kuitenkin aktiivisemmin, 2000-luvun kirjallisuutta on luokassa 21 %. Vähäisen käytön takia suuri osa muita maita koskevaa yleistä taidehistoriallista kirjallisuutta tullaankin muuton yhteydessä poistamaan kirjaston kokoelmista. Aineisto koostuu yleisestä taidehistoriasta, kuvataiteesta, taiteilijamonografioista ja kirkkotaiteesta. Suomen taidehistoriaa on noin 500 nimekettä, Pohjoismaiden noin 350 nimekettä, Baltian noin 50 nimekettä ja muiden maiden noin 2 200 nimekettä. Kokoelma on monikielistä. Suurimmat kieliryhmät ovat: saksa 36 %, englanti 18 %, suomi 15 %, ruotsi 13 % ja ranska 8 %. Kirjastossa on lisäksi venäläisen taidehistorian kokoelma, jonkun verran taidemuseoiden näyttelyluetteloita sekä taideteollisuuden ja arkkitehtuurin kokoelmat. Ennen vuotta 1900 julkaistu kirjallisuus on siirretty ei lainattavaan kokoelmaan. Kirjaston muuttoon v. 2011 liittyneiden poistojen jälkeen kokoelmissa oli 2 666 nidettä 19.12.2011 (vrt. 3 400 ennen muuttoa). Poistettu oli lähinnä muiden maiden yleistä taidehistoriaa, jota oli nyt 1 750 (vrt. 2 200). Kokoelmissa on lisäksi muutama sata venäläiseen taidehistorian kokoelmaan kuuluvaa kirjaa. Arkkitehtuurin kokoelmassa oli v. 2011 n. 400 Suomen, n. 400 Pohjoismaiden, n. 150 Baltian, n. 140 Venäjän ja n. 630 muiden maiden arkkitehtuuriin ja rakennustaiteen historiaan ja interiööreihin liittyvää teosta, joista mainittakoon kirkkorakennuksiin liittyvä verraten laaja kirjallisuus ja pieni puutarhataiteen kokoelma.

Degradação fotoeletroquímica do corante azul QR 19 em solução aquosa

In this work the degradation capacity of a photo-electrocatalytic system was evaluated, mainly regarding the effect of the electrolyte solution on the degradation capacity toward a reactive textile dye. In the presence of NaCl the photo-electrochemical process shows high degradation efficiency, permitting almost total color removal in treatment of about 5 min. In view of the low degradation efficiency observed for the photocatalytic process it is possible to assume that the high degradation efficiency of the process is a function of electrochemical generation of oxidant active chlorine species, which are subsequently transformed to higher oxidant radical forms.