Cannabis et Grossesse

Le cannabis est une drogue dont la consommation ne cesse d augmenter, chez les jeunes notamment, mais également chez les femmes enceintes. Pour elles, comme pour leur(s) futur(s) enfant(s), cette consommation est à risque et peut avoir des conséquences à court terme, avec l apparition de malformations foetales, mais aussi à long terme avec des problèmes de mémoire, de concentration, d apprentissage et un risque augmenté de développer une psychose schizophrénique. Dans un tel contexte, le pharmacien d officine et les sages femmes ont un rôle de prévention, d écoute et de soutien.ROUEN-BU Médecine-Pharmacie (765402102) / SudocSudocFranceF

Efficient and selective molecular catalyst for the CO 2 -to-CO electrochemical conversion in water

Substitution of the four paraphenyl hydrogens of iron tetraphenylporphyrin by trimethylammonio groups provides a watersoluble molecule able to catalyze the electrochemical conversion of carbon dioxide into carbon monoxide. The reaction, performed in pH-neutral water, forms quasi-exclusively carbon monoxide with very little production of hydrogen, despite partial equilibration of CO 2 with carbonic acid-a low pK a acid. This selective molecular catalyst is endowed with a good stability and a high turnover frequency. On this basis, prescribed composition of CO-H 2 mixtures can be obtained by adjusting the pH of the solution, optionally adding an electroinactive buffer. The development of these strategies will be greatly facilitated by the fact that one operates in water. The same applies for the association of the cathode compartment with a proton-producing anode by means of a suitable separator. CO 2 -to-CO conversion | contemporary energy challenges | electrochemistry | catalysis | solar fuels O ne of the most important issues of contemporary energy and environmental challenges consists of reducing carbon dioxide into fuels by means of sunlight (1-3). One route toward this ultimate goal is to first convert solar energy into electricity, which will then be used to reduce CO 2 electrochemically. Direct electrochemical injection of an electron into the CO 2 molecule, forming the corresponding anion radical CO 2 .− requires a very high energy [the standard potential of the CO 2 / CO 2 .− couple is indeed −1.97 V vs. normal hydrogen electrode (NHE) in N,N′dimethylformamide (DMF)] (4, 5). Electrochemical conversion of CO 2 to any reaction product thus requires catalytic schemes that preferably avoid this intermediate. Carbon monoxide may be an interesting step en route to the desired fuels because it can be used as feedstock for the synthesis of alkanes through the classic Fischer-Tropsch process. A number of molecular catalysts for the homogeneous electrochemical CO 2 -to-CO conversion have been proposed. They mainly derive from transition metal complexes by electrochemical generation of an appropriately reduced state, which is restored by the catalytic reaction. So far, nonaqueous aprotic solvents (mostly DMF and acetonitrile) have been used for this purpose (5-16). Brönsted acids have been shown to boost catalysis. However, they should not be too strong, at the risk of leading to H 2 formation at the expense of the CO. Trifluoroethanol and water (possibly in large amounts) have typically played the role of a weak acid in the purpose of boosting catalysis while avoiding hydrogen evolution. One of the most thoroughly investigated families of transitionmetal complex catalysts of CO 2 -to-CO conversion is that of iron porphyrins brought electrochemically to the oxidation degree 0. The importance of coupling electron transfer and introduction of CO 2 into the coordination sphere of iron with proton transfers required by the formation of CO, CO 2 + 2e − , appeared from the very beginning of these studies. Sustained formation of CO was indeed only achieved upon addition of weak and Lewis acids (20, The results thus obtained in nonaqueous or partially aqueous media enabled the discovery of remarkably efficient and selective catalysts of the CO 2 -to-CO conversion. They were also the occasion of notable advances in terms of mechanisms and theory of concerted bond-breaking proton-electron transfer (29). It must, however, be recognized that, from the point of view of practical applications, the use of nonaqueous solvents is not the most exciting aspect of these results. One would rather like to use water as the solvent, which would render more viable the CO 2 -to-CO half-cell reaction as well as its association with a water-oxidation anode through a proton-exchange membrane. Significance CO 2 -to-CO electrochemical conversion is a key step in the production of liquid fuels through dihydrogen-reductive FischerTropsch chemistry. Among molecular catalysts, iron porphyrins reduced electrochemically to the Fe(0) state are particularly efficient and led to a deeper understanding of mechanisms involving coupled bond-breaking proton-electron transfer processes. The replacement of nonaqueous solvents by water should make the CO 2 -to-CO half-cell reaction much more attractive for applications, particularly because it would allow association with a water-oxidation anode through a protonexchange membrane. Here it is demonstrated that electrochemical CO production catalyzed by a water-soluble iron porphyrin can occur with high catalytic efficiency. Manipulation of pH and buffering then allows conversions from those involving complete CO selectivity to ones with prescribed CO-H 2 mixtures

Efficient and selective molecular catalyst for the CO 2 -to-CO electrochemical conversion in water

Substitution of the four paraphenyl hydrogens of iron tetraphenylporphyrin by trimethylammonio groups provides a watersoluble molecule able to catalyze the electrochemical conversion of carbon dioxide into carbon monoxide. The reaction, performed in pH-neutral water, forms quasi-exclusively carbon monoxide with very little production of hydrogen, despite partial equilibration of CO 2 with carbonic acid-a low pK a acid. This selective molecular catalyst is endowed with a good stability and a high turnover frequency. On this basis, prescribed composition of CO-H 2 mixtures can be obtained by adjusting the pH of the solution, optionally adding an electroinactive buffer. The development of these strategies will be greatly facilitated by the fact that one operates in water. The same applies for the association of the cathode compartment with a proton-producing anode by means of a suitable separator. CO 2 -to-CO conversion | contemporary energy challenges | electrochemistry | catalysis | solar fuels O ne of the most important issues of contemporary energy and environmental challenges consists of reducing carbon dioxide into fuels by means of sunlight (1-3). One route toward this ultimate goal is to first convert solar energy into electricity, which will then be used to reduce CO 2 electrochemically. Direct electrochemical injection of an electron into the CO 2 molecule, forming the corresponding anion radical CO 2 .− requires a very high energy [the standard potential of the CO 2 / CO 2 .− couple is indeed −1.97 V vs. normal hydrogen electrode (NHE) in N,N′dimethylformamide (DMF)] (4, 5). Electrochemical conversion of CO 2 to any reaction product thus requires catalytic schemes that preferably avoid this intermediate. Carbon monoxide may be an interesting step en route to the desired fuels because it can be used as feedstock for the synthesis of alkanes through the classic Fischer-Tropsch process. A number of molecular catalysts for the homogeneous electrochemical CO 2 -to-CO conversion have been proposed. They mainly derive from transition metal complexes by electrochemical generation of an appropriately reduced state, which is restored by the catalytic reaction. So far, nonaqueous aprotic solvents (mostly DMF and acetonitrile) have been used for this purpose (5-16). Brönsted acids have been shown to boost catalysis. However, they should not be too strong, at the risk of leading to H 2 formation at the expense of the CO. Trifluoroethanol and water (possibly in large amounts) have typically played the role of a weak acid in the purpose of boosting catalysis while avoiding hydrogen evolution. One of the most thoroughly investigated families of transitionmetal complex catalysts of CO 2 -to-CO conversion is that of iron porphyrins brought electrochemically to the oxidation degree 0. The importance of coupling electron transfer and introduction of CO 2 into the coordination sphere of iron with proton transfers required by the formation of CO, CO 2 + 2e − , appeared from the very beginning of these studies. Sustained formation of CO was indeed only achieved upon addition of weak and Lewis acids (20, The results thus obtained in nonaqueous or partially aqueous media enabled the discovery of remarkably efficient and selective catalysts of the CO 2 -to-CO conversion. They were also the occasion of notable advances in terms of mechanisms and theory of concerted bond-breaking proton-electron transfer (29). It must, however, be recognized that, from the point of view of practical applications, the use of nonaqueous solvents is not the most exciting aspect of these results. One would rather like to use water as the solvent, which would render more viable the CO 2 -to-CO half-cell reaction as well as its association with a water-oxidation anode through a proton-exchange membrane. Significance CO 2 -to-CO electrochemical conversion is a key step in the production of liquid fuels through dihydrogen-reductive FischerTropsch chemistry. Among molecular catalysts, iron porphyrins reduced electrochemically to the Fe(0) state are particularly efficient and led to a deeper understanding of mechanisms involving coupled bond-breaking proton-electron transfer processes. The replacement of nonaqueous solvents by water should make the CO 2 -to-CO half-cell reaction much more attractive for applications, particularly because it would allow association with a water-oxidation anode through a protonexchange membrane. Here it is demonstrated that electrochemical CO production catalyzed by a water-soluble iron porphyrin can occur with high catalytic efficiency. Manipulation of pH and buffering then allows conversions from those involving complete CO selectivity to ones with prescribed CO-H 2 mixtures

Time to treatment with bridging intravenous alteplase before endovascular treatment:subanalysis of the randomized controlled SWIFT-DIRECT trial.

BACKGROUND We hypothesized that treatment delays might be an effect modifier regarding risks and benefits of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT). METHODS We used the dataset of the SWIFT-DIRECT trial, which randomized 408 patients to IVT+MT or MT alone. Potential interactions between assignment to IVT+MT and expected time from onset-to-needle (OTN) as well as expected time from door-to-needle (DTN) were included in regression models. The primary outcome was functional independence (modified Rankin Scale (mRS) 0-2) at 3 months. Secondary outcomes included mRS shift, mortality, recanalization rates, and (symptomatic) intracranial hemorrhage at 24 hours. RESULTS We included 408 patients (IVT+MT 207, MT 201, median age 72 years (IQR 64-81), 209 (51.2%) female). The expected median OTN and DTN were 142 min and 54 min in the IVT+MT group and 129 min and 51 min in the MT alone group. Overall, there was no significant interaction between OTN and bridging IVT assignment regarding either the functional (adjusted OR (aOR) 0.76, 95% CI 0.45 to 1.30) and safety outcomes or the recanalization rates. Analysis of in-hospital delays showed no significant interaction between DTN and bridging IVT assignment regarding the dichotomized functional outcome (aOR 0.48, 95% CI 0.14 to 1.62), but the shift and mortality analyses suggested a greater benefit of IVT when in-hospital delays were short. CONCLUSIONS We found no evidence that the effect of bridging IVT on functional independence is modified by overall or in-hospital treatment delays. Considering its low power, this subgroup analysis could have missed a clinically important effect, and exploratory analysis of secondary clinical outcomes indicated a potentially favorable effect of IVT with shorter in-hospital delays. Heterogeneity of the IVT effect size before MT should be further analyzed in individual patient meta-analysis of comparable trials. TRIAL REGISTRATION NUMBER URL: https://www. CLINICALTRIALS gov ; Unique identifier: NCT03192332

ERS: A simple scoring system to predict early recurrence after surgical resection for hepatocellular carcinoma.

peer reviewed[en] BACKGROUND: Surgical resection (SR) is a potentially curative treatment of hepatocellular carcinoma (HCC) hampered by high rates of recurrence. New drugs are tested in the adjuvant setting, but standardised risk stratification tools of HCC recurrence are lacking. OBJECTIVES: To develop and validate a simple scoring system to predict 2-year recurrence after SR for HCC. METHODS: 2359 treatment-naïve patients who underwent SR for HCC in 17 centres in Europe and Asia between 2004 and 2017 were divided into a development (DS; n = 1558) and validation set (VS; n = 801) by random sampling of participating centres. The Early Recurrence Score (ERS) was generated using variables associated with 2-year recurrence in the DS and validated in the VS. RESULTS: Variables associated with 2-year recurrence in the DS were (with associated points) alpha-fetoprotein (100: 3), size of largest nodule (≥40 mm: 1), multifocality (yes: 2), satellite nodules (yes: 2), vascular invasion (yes: 1) and surgical margin (positive R1: 2). The sum of points provided a score ranging from 0 to 11, allowing stratification into four levels of 2-year recurrence risk (Wolbers' C-indices 66.8% DS and 68.4% VS), with excellent calibration according to risk categories. Wolber's and Harrell's C-indices apparent values were systematically higher for ERS when compared to Early Recurrence After Surgery for Liver tumour post-operative model to predict time to early recurrence or recurrence-free survival. CONCLUSIONS: ERS is a user-friendly staging system identifying four levels of early recurrence risk after SR and a robust tool to design personalised surveillance strategies and adjuvant therapy trials

Family Firms and Firm Performance: Evidence from Japan

Corrigendum: Nature Structural and Molecular Biology 16 (12), 1331 (2009) doi:10.1038/nsmb1209-1331bInternational audienceThioredoxins (Trxs) are oxidoreductase enzymes, present in all organisms, that catalyze the reduction of disulfide bonds in proteins. By applying a calibrated force to a substrate disulfide, the chemical mechanisms of Trx catalysis can be examined in detail at the single-molecule level. Here we use single-molecule force-clamp spectroscopy to explore the chemical evolution of Trx catalysis by probing the chemistry of eight different Trx enzymes. All Trxs show a characteristic Michaelis-Menten mechanism that is detected when the disulfide bond is stretched at low forces, but at high forces, two different chemical behaviors distinguish bacterial-origin from eukaryotic-origin Trxs. Eukaryotic-origin Trxs reduce disulfide bonds through a single-electron transfer reaction (SET), whereas bacterial-origin Trxs show both nucleophilic substitution (SN2) and SET reactions. A computational analysis of Trx structures identifies the evolution of the binding groove as an important factor controlling the chemistry of Trx catalysis

La dopamine dans tous ses états

International audienceLes dérèglements par excès ou par défaut de la libération de la dopamine sont impliqués dans de nombreuses et souvent graves affections neurologiques ou psychiatriques : la maladie de Parkinson, le syndrome des jambes sans repos, certains troubles de la veille ou du sommeil, des états dépressifs, toutes les toxicomanies et autres addictions, la schizophrénie, l'hyperactivité de l'enfant avec déficit de l'attention, les troubles des conduites alimentaires, certains troubles endocriniens, des troubles de la régulation de la température corporelle...À partir de vignettes cliniques présentant ces affections, le Professeur Jean Costentin explicite les mécanismes dopaminergiques qui les sous-tendent et permet au lecteur de comprendre le recours thérapeutique à des médicaments manipulant la transmission dopaminergique

Importance de la pharmacologie

Les grandes classes de médicaments psychotropes ont été découvertes presque fortuitement, à partir d'essais pratiqués sur l'homme. L'explosion des études que ces découvertes ont suscitée et le renforcement considérable de l'éthique des essais cliniques ont ouvert des avenues à l'expérimentation animale. Les modèles développés pour l'étude préclinique de ces médicaments psychotropes peuvent être distingués en : modèles homologues – qui s'appliquent à reproduire l'étiologie de l'affection contre laquelle on veut développer des médicaments; modèles isomorphes – qui reproduisent certains symptômes d'une pathologie, sans pour autant procéder des mêmes mécanismes étiologiques ; modèles prédictifs – qui évaluent l'efficacité d'un traitement sur des paramètres qui ne participent pas à l'affection à traiter, mais qui mobilisent des cibles biologiques de même type que celles impliquées dans cette affection ; modèles théoriques ou explicatifs – qui visent à élucider le mécanisme d'action d'agents développant des effets neuro/psychotropes, avec parmi ceux ci : l'invalidation de gènes codant des cibles biologiques définies ; la neutralisation d'ARNm par des oligodésoxynucléotides (ODN) antisens pour s'opposer, là aussi, à la synthèse de certaines cibles biologiques ; la concentration, par reproduction dirigée, de gènes dont l'association aboutit au développement d'une affection. Chacune de ces approches est illustrée par un exemple développé au sein de l'Unité de Neuropsychopharmacologie de Rouen : il s'agit du spectre comportemental des souris dont le gène codant les récepteurs A2A de l'adénosine a été invalidé ; de l'extinction de la synthèse des récepteurs ORL1 de la nociceptine ou des récepteurs NTR2 de la neurotensine, aux fins de caractériser leurs fonctions ; de la concentration obtenue chez la souris, par reproduction dirigée, d'un phénotype correspondant à celui de la dépression. Ces développements présentent certaines évolutions récentes de la neuropsychopharmacologie et visent à souligner sa vitalité

Pharmacologie à l'officine: Pour la délivrance éclairée de l'ordonnance

International audienceVademecum indispensable à la délivrance des médicaments et à l'exercice de la profession officinale, cette nouvelle édition, actualisée et enrichie, offre au pharmacien, au praticien hospitalier, à l'étudiant et l'interne en pharmacie, une synthèse des connaissances et des compétences pharmacothérapeutiques, avec : - une orientation inédite, centrée sur le médicament et les interrelations entre physiopathologie, pharmacologie et toxicologie ; - des tableaux didactiques, facilitant l'accès à l'information nécessaire à la délivrance du médicament ; - une lecture critique de l'ordonnance, des éléments de pharmacocinétique pratique, 46 fiches pharmacothérapeutiques et 10 ordonnances analysées et commentées