Pharmacokinetics, thrombogenicity and safety of a double viral inactivated factor IX concentrate compared with a prothrombin complex concentrate

Therapeutic options for developing countries have to assure an optimum safety and efficacy and low-cost antihaemophilic concentrates. A single blind randomized crossover study was carried out in 12 previously treated HB patients, comparing the pharmacokinetics (PK), thrombogenicity (TG) and safety of two plasma-derived double-inactivated (solvent/detergent heating at 100?C, 30 min) factor IX (FIX) concentrates, UMAN COMPLEX DI (product A) [plasma-derived prothrombin concentrates (PCC)] and a high purity FIX concentrate AIMAFIX DI (product B, HPFIX). In a non-bleeding state, they received one single intravenous dose 50 IU FIX kg−1 of PCC or HPFIX, and after a wash-out period of 14 days, the other product. We evaluated acute tolerance and determined PK parameters based on FIX levels measured over a 50 h postinfusion period. We studied fibrinogen, platelets, antithrombin, F1 + 2, TAT, D-dimer, over a 360 min postinfusion period. Ten cases remained in on-demand treatment for 6 months, five with PCC and five with HPFIX. PK and anti-FIX inhibitors were repeated at 3 and 6 months. No inhibitors were detected. PK values (PCC vs. HPFIX): clearence (CL; mL h−1 kg−1) 5.2 ? 1.4 vs. 6.5 ? 1.4; the volume of distribution at steady state (mL kg−1) 154.9 ? 54.9 vs. 197.5 ? 72.5; mean residence time (h) 29.7 ? 8.1 vs. 30.7 ? 9.2; T1/2 (h) 22.3 ? 7 vs. 23.5 ? 12.3; incremental recovery (IR; U dL−1 U−1 kg−1) 0.96 ? 0.17 vs. 0.76 ? 0.13. HPFIX showed significant lower IR and higher CL. There were no differences in PK at 3 and 6 months. In TG, significant increments in TAT and F1 + 2 at 30 min and 6 h were found with PCC. Product B PK results agrees with reported results for other HPFIX preparations. Use of PCC product A has to consider its thrombogenic activity

IODINE SPECTROMETER FOR LOW-SHIFTED LIGHT-SCATTERING

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The Experience in Nicaragua: Childhood Leukemia in Low Income Countries—The Main Cause of Late Diagnosis May Be “Medical Delay”

Background. The event-free survival for pediatric leukemia in low-income Countries is much lower than in high-income countries. Late diagnosis, which is regarded as a contributing factor, may be due to “parental” or “medical” delay. Procedures. The present study analyses determinants of lag time from first symptoms to diagnosis of leukemia, comparing pediatric (0–16 years old) patients in two referral centers, one in Nicaragua and one in Italy. An observational retrospective study was conducted to assess factors influencing the time to diagnosis. Results. 81 charts of children diagnosed with acute myeloid leukemia or lymphoblastic leukemia were analyzed from each centre. Median lag time to diagnosis was higher in Nicaragua than in Italy (29 versus 14 days, P < 0.001) and it was mainly due to “physician delay” (16.5 versus 7 days, P < 0.001), whereas “patient delay” from symptoms to first medical assessment was similar in the two centers (7 versus 5 days, P = 0.27). Moreover, median lag time from symptoms to diagnosis was decreased in Nicaraguan districts were a specific training program upon childhood oncological diseases was carried out (20.5 versus 40 days, P = 0.0019). Conclusions. Our study shows that delay in diagnosis of childhood leukemia is mainly associated with “physician delay” and it may be overcome by programs of continuous medical education

Design and development of a speech synthesis software for colombian spanish applied to communication through mobile devices

In several scenarios of everyday life, there is a need to communicate orally with other people. However, various technological solutions such as mobile phones cannot be used in places such as meetings, classrooms, or conference rooms without disrupting the activities of people around the speaker. This research develops a tool that enables people to establish a conversation in a public place without disrupting the surrounding environment. To this end, a speech synthesizer is implemented on a personal computer connected to a cell phone, which allows one to establish a mobile call without using the human voice. The speech synthesizer uses the diphone concatenation technique and is developed specifically for the Spanish from Colombia. A mathematical description of the synthesizer shows the decomposition of the synthesizer into various mutually independent processes. Several user-acceptance and quality tests of the obtained signal were performed to evaluate the performance of the tool. The results show a high signal to noise ratio of generated signals and a high intelligibility of the tool

Prevalence and Predictors of Posttraumatic Stress Symptomatology Among Burn Survivors

Burns can be a traumatic and stressful experience, although each patient may respond in very different ways. Objective: The aim of this study was to explore the variability on Post-traumatic stress disorder and Acute Stress Disorder prevalence, and evaluate the specific weight of different variables on Post-traumatic stress disorder development among adult burn patients. Methods: A systematic review was carried out to explore the prevalence of acute and Post-traumatic stress disorder and identify their predictors. Meta-analytical methods were used to explore the strength of association between Posttraumatic stress disorder and the latter. From an initial pool of 190 studies, 24 were used in the systematic review, and only 19studies could be used for the meta-analysis due to different methodological limitations. Outcomes: The prevalence of Acute Stress Disorder at baseline ranged from 2 to 30% and prevalence of Post-traumatic stress disorder ranged from 3 to 35% at 1 month, 2-40% between 3 and 6 months, 9-45% in the year post-injury and ranged 7-25% more than two years later. Life threat perception was the strongest predictor for Post-traumatic stress disorder occurrence, followed by acute intrusive symptoms and pain associated with burn injuries. Conclusions: Predictive variables identified in this research may be useful in targeting burn patients who are at risk for developing post-traumatic stress symptoms and stress related psychological symptoms