45 research outputs found
Dynamics of the transcriptional landscape during human fetal testis and ovary development
Acknowledgements We thank all members of the SEQanswers forums for helpful advice; Steven Salzberg and Cole Trapnell for continuous support with the ‘Tuxedo’ suite; and the UCSC Genome team members. Sequencing was performed by the GenomEast platform, a member of the ‘France Génomique’ consortium (ANR-10-INBS-0009). We thank Ms Linda Robertson, Ms Margaret Fraser, Ms Samantha Flannigan (University of Aberdeen) and the staff at Grampian NHS Pregnancy Counselling Service and all the staff of the Department of Obstetrics and Gynecology of the Rennes Sud Hospital for their expert assistance and help, and the participating women, without whom this study would not have been possible. The authors are grateful for Ms Gersende Lacombe and Mr Laurent Deleurme from the Biosit CytomeTri cytometry core facility of Rennes 1 University. Funding French National Institute of Health and Medical Research (Inserm); University of Rennes 1; French School of Public Health (EHESP); Swiss National Science Foundation [SNF n° CRS115_171007 to B.J.]; the French National Research Agency [ANR n° 16-CE14-0017-02 and n°18-CE14-0038-02 to F.C]; Medical Research Council [MR/L010011/1 to PAF]; European Community’s Seventh Framework Programme (FP7/2007–2013) [under grant agreement no 212885 to PAF]; European Union’s Horizon 2020 Research and Innovation Programme [under grant agreement no 825100 to P.A.F. and S.M.G.].Peer reviewedPostprin
Evaluation of troponin T on AQT90 Flex and COBAS 8000 as a rule in/out tool in an emergency ward
BACKGROUND: Troponin measurement is the gold standard for diagnosis of Acute Myocardial Infarction (AMI). Troponin (highly sensitive (hs), T or I) is measured by immunochemistry instrument or by Point of Care (POCT). POCT can be useful in emergency lab or ward for a faster diagnosis of patients with chest pain. Our study compared analytical performance of a POCT AQT90 Flex (Radiometer Medical) (AQT) and TnThs Cobas 8000 (Roche Diagnostics) (Cobas). We also compared the clinical performance of both methods at recommended cut-off (14 ng/L for Cobas and 30 ng/
L for AQT).
METHODS: We selected 104 patients (296 samples) (range: 6-13822 ng/L) admitted in the Emergency ward for which at least 1 troponin determination (Cobas 8000) had been re-quested in the past 24 hours according to rule in/out procedure applied by this ward. Samples were then measured with the AQT. Inter-assay CV was maximum 8.6% and 9.6% for Cobas and AQT respectively. The cut-off defined as the 99th percentile for Roche was 14 ng/L and the recommended decision threshold value was 30 ng/L for Radiometer. Retrospective analysis of final diagnostic was obtained for all
participants: we considered as “true positive” patients for whom a final diagnostic was ST segment-Elevation Myocardial Infarction (STEMI) or non STEMI (NSTEMI).
RESULTS: On the whole range of measure, the 2 methods showed a good correlation (r2=0.98). Regression equation was Cobas = 0.98 AQT + 31 ng/L (95%CI of the intercept: (26.7;37.7) and 95% CI of the slope (0.96;1)). When we stratified, for the values <54 ng/L, the equation became Cobas = 0.52 AQT +1.1 ng/L (95%CI of the intercept: (-4.8;5.5) and 95% CI of the slope (0.39;0.69)). Bland and Altman plot did not show any bias. At admission [2-7 hours], 78 (81%) of admitted
patients were finally considered as AMI, sensitivity was 92 % [96%] for Cobas and 78% [91%] for AQT. Specificity was 15% for Cobas (cut-off 14ng/L) or 73% (cut-off 54 ng/L) and 76% for AQT.
CONCLUSIONS: Overall, there was a good correlation between the 2 methods. However, using a cut-off of 14 ng/L for Cobas is questionable for a rule in/out procedure in an emergency ward. Using 54 ng/L for Roche and 30 ng/L for AQT would have led to the best discrimination between patients presenting AMI or not
Solid Lipid Microparticles: Formulation, Preparation, Characterisation, Drug Release and Applications
This review details the properties of solid lipid microparticles (SLMs): a promising drug carrier system that has been until now rather unexploited. First, the advantages of SLMs compared with other drug carrier systems are listed. Then an overview of SLM manufacturing compounds and techniques is presented. A detailed discussion of the characteristics of SLMs follows, and includes the determination of particle size distribution, the determination of SLM morphology, the solid-state analysis, the determination of SLM drug loading and the factors influencing it. The in vitro drug release studies that have been carried out so far and the parameters affecting them are also described. Some preliminary in vivo aspects (in vivo drug release studies, biocompatibility studies and in vivo fate) are also considered
Benzodiazepine Use and Deprescribing in Belgian Nursing Homes: Results from the COME-ON Study.
To describe the use and deprescribing of benzodiazepine receptor agonists (BZRAs) among nursing home residents (NHRs), to evaluate appropriateness of use and to identify factors associated with BZRA use and deprescribing. Posthoc analysis of the Collaborative Approach to Optimize Medication Use for Older People in Nursing Homes (COME-ON) study, a cluster controlled trial that evaluated the impact of a complex intervention on potentially inappropriate prescriptions (PIPs) in nursing homes (NHs). A total of 54 NHs in Belgium. A total of 797 NHRs included in the study who had complete medical, clinical, and medication information at baseline and at the end of the study (month 15). Data were recorded by participating healthcare professionals. Reasons why BZRA use was considered as PIPs were assessed using the 2019 American Geriatrics Society Beers Criteria® and the Screening Tool of Older Persons' Prescriptions (STOPP) criteria, version 2. Deprescribing included complete cessation or decreased daily dose. We identified factors at the NHR, prescriber, and NH levels associated with BZRA use and BZRA deprescribing using multivariable binary and multinomial logistic regression, respectively. At baseline, 418 (52.4%) NHRs were taking a BZRA. The use of BZRA for longer than 4 weeks, with two or more other central nervous system active drugs, and in patients with delirium, cognitive impairment, falls, or fractures was found in more than 67% of BZRA users. Eight NHR-related variables and two prescriber-related variables were associated with regular BZRA use. Deprescribing occurred in 28.1% of BZRA users (32.9% in the intervention group and 22.1% in the control group). In addition to four other factors, dementia (odds ratio [OR] = 2.35; 95% confidence interval [CI] = [1.45-3.83]) and intervention group (OR = 1.74; 95% CI = 1.07-2.87) were associated with deprescribing. Use of BZRAs was highly prevalent, and reasons to consider it as PIP were frequent. Deprescribing occurred in one-fourth of NHRs, which is encouraging. Future interventions should focus on specific aspects of PIPs (ie, indication, duration, drug-drug and drug-disease interactions) as well as on nondementia patients
Benzodiazepine Use and Deprescribing in Belgian Nursing Homes: Results from the COME‐ON
BACKGROUND/OBJECTIVES: To describe the use and deprescribing of benzodiazepine receptor agonists (BZRAs) among nursing home residents (NHRs), to evaluate appropriateness of use and to identify factors associated with BZRA use and deprescribing.
DESIGN: Posthoc analysis of the Collaborative Approach to Optimize Medication Use for Older People in Nursing Homes (COME-ON) study, a cluster controlled trial that evaluated the impact of a complex intervention on potentially inappropriate prescriptions (PIPs) in nursing homes (NHs).
SETTING: A total of 54 NHs in Belgium.
PARTICIPANTS: A total of 797 NHRs included in the study who had complete medical, clinical, and medication information at baseline and at the end of the study (month 15).
MEASUREMENTS: Data were recorded by participating healthcare professionals. Reasons why BZRA use was considered as PIPs were assessed using the 2019 American Geriatrics Society Beers Criteria® and the Screening Tool of Older Persons' Prescriptions (STOPP) criteria, version 2. Deprescribing included complete cessation or decreased daily dose. We identified factors at the NHR, prescriber, and NH levels associated with BZRA use and BZRA deprescribing using multivariable binary and multinomial logistic regression, respectively.
RESULTS: At baseline, 418 (52.4%) NHRs were taking a BZRA. The use of BZRA for longer than 4 weeks, with two or more other central nervous system active drugs, and in patients with delirium, cognitive impairment, falls, or fractures was found in more than 67% of BZRA users. Eight NHR-related variables and two prescriber-related variables were associated with regular BZRA use. Deprescribing occurred in 28.1% of BZRA users (32.9% in the intervention group and 22.1% in the control group). In addition to four other factors, dementia (odds ratio [OR] = 2.35; 95% confidence interval [CI] = [1.45-3.83]) and intervention group (OR = 1.74; 95% CI = 1.07-2.87) were associated with deprescribing.
CONCLUSION: Use of BZRAs was highly prevalent, and reasons to consider it as PIP were frequent. Deprescribing occurred in one-fourth of NHRs, which is encouraging. Future interventions should focus on specific aspects of PIPs (ie, indication, duration, drug-drug and drug-disease interactions) as well as on nondementia patients