Reassessment of the reproducibility of Technetium-99m mercaptoacetyltriglycine clearance

BACKGROUND: Conflicting results have been published concerning the reproducibility of Tc-99m MAG3 clearance. The aim of the study was to reevaluate again this reproducibility on a large prospective series of healthy volunteers. MATERIAL AND METHODS: Fifty subjects underwent three successive tests performed at 1-week interval. The physiological conditions were controlled as much as possible and all experimental measurements were rigorously double-checked. Renal clearances were calculated using single sample algorithms. RESULTS: Thin layer chromatography demonstrated a radiochemical purity of more than 92% (mean 93.8%; SD 1.6%; range 92.0–96.4%). The mean (and SD) of 44th minute plasma concentrations for the three successive measurements were respectively 1.8 ± 0.4, 2.1 ± 0.4 and 1.9 ± 0.4 (%dose/liter). The mean changes (and S.D. of differences) between two tests were 0.26 ± 0.29, –0.08 ± 0.5 and 0.18 ± 0.30 respectively between tests 1 and 2, tests 1 and 3, and tests 2 and 3. Using Bubeck’s algorithm, the mean clearance values (ml/min/1.73 m2) were 268.8 (range 201.4–336.8), 247.2 (range 170.5–290.3), and 262.8 (range 187.4–340.0) respectively for the first, second and third measurements. Using Russell’s approach, the mean clearance values were respectively 314.9 (range: 208.7–441.7), 280.1 (range: 167.5–358.6), and 305.4 (range: 189.5–447.9). CONCLUSIONS: High differences were observed between the 3 tests. Using Russell´s formula, the SD of differences between two tests was respectively 35.8, 47.7 and 57.7 ml/min/1.73 m2 between tests 1 and 2, tests 1 and 3, and tests 2 and 3. Whether such a large variability is acceptable in clinical practice depends solely on what the clinician is expecting

Values and objectives of the EU in light of Opinion 1/17: ‘Trade for all’, above all

In Opinion 1/17 the Court of Justice of the European Union (CJEU) ruled that the new Investment Court System (ICS) in the Canada–EU Comprehensive Economic and Trade Agreement (CETA) is compatible with the EU constitutional framework. This article examines the CJEU’s analysis of the ICS in its Opinion through the prism of EU values and objectives. Given the judicial nature of the ICS, the article unfolds around the concept of the rule of law. The scope and the content of this core EU value are considered under both EU law and the European Convention on Human Rights (ECHR). In particular, the ICS is analysed in light of the two core rule-of-law requirements: equal treatment and the independence of courts, enshrined in Articles 20 and 47 of the Charter of Fundamental Rights (CFR). Importantly, in Opinion 1/17 the CJEU for the first time applied Article 47 CFR to a court outside the EU judicial system. While the CJEU ruled that the ICS complies with the CFR rule-of-law criteria,this article argues that it nevertheless falls short of the rule-of-law standards required for judicial bodies under EU law. The article demonstrates that the CJEU prioritises free and fair trade as the CETA’s core objective, rather than the rule of law, and endorses the ICS as the conditio sine qua non of guaranteeing such trade. The Court’s findings have wider consequences for the rule of law in international law as the EU continues to pursue the establishment of a Multilateral Investment Court (MIC)

La armonización de legislaciones, mercado interior y medio ambiente: los retos del pacto verde

Although it was not mentioned in the 1957 Treaty of Rome, environmental concerns have, through the various treaty reforms, gradually been able to establish themselves as one of the greatest values enshrined in the treaties. Henceforth, environmental protection is not only a core objective of the Union, it has also been placed on equal footing with economic growth and the internal market. The choice of legal basis of EU measures aiming at protecting the environment represents a critical juncture in relations between institutions, as well as the relations between the Member States and the EU. It is not the case that every single provision even remotely relating to environmental issues has been passed under the only chapter of the Treaty dedicated to environmental policy. As the EU harmonisation measures aim at avoiding distortions of competition between undertakings, a significant number of product-oriented directives and regulations which have a direct impact on the internal market, and in particular those which lay down product standards, have been adopted on the base of Article 114 TFEU, a provision empowering the EU institutions to enact all measures affecting the establishment and the functioning of the internal market. It is thus the aim of this article to assess in line with the new regulatory developments stemming from the Green Deal whether the environment benefits from a greater level of protection thanks to the recourse to the genuine environmental basis (Article 192 TFEU), or thanks to the internal market legal basis (Article 114 TFEU).Este trabajo expone cómo las nuevas propuestas normativas previstas por la Comisión Europea en el marco del Green Deal para alcanzar la neutralidad climática en 2050 se adoptarán sobre la base jurídica medioambiental genuina (artículo 192 del TFUE), o gracias a la base jurídica del mercado interior (artículo 114 del TFUE)