Le médicament générique au Maroc: le point de vue du consommateur

Introduction: Le médicament générique est souvent une origine de préjugés négatifs et de méfiance chez les professionnels de santé et les patients. Ceci pourrait être dû à plusieurs facteurs entre autre le manque des connaissances du patient sur ces médicaments. Le but de notre étude était d'évaluer l'information du consommateur sur les médicaments génériques et apprécier leur utilisation de ces médicaments. Méthodes: Il s'agit d'une étude transversale réalisée de Janvier à Mars 2010 auprès de 251 sujets. Un questionnaire comprenant dix questions fermées a été utilisé. Les questions concernaient l'évaluation des connaissances sur les médicaments génériques, les sources d'information, le degré de confiance et d'information des patients sur ces médicaments. Une analyse descriptive simple des différentes variables a été réalisée. Résultats: Dans notre étude, 126 sujets (50,2%) ont répondu connaître les médicaments génériques. Parmi eux, 52,3% les utilisaient et 67,4% estimaient qu'ils étaient insuffisamment informés sur ces médicaments. Les cadres supérieurs et les étudiants ont représenté la catégorie qui utilisait le plus les médicaments génériques (respectivement dans 40,9% et 25,7%) et qui était la mieux informée (respectivement dans 61,9% et 23,81%). Le faible coût a été la principale motivation d'utilisation du médicament générique (93,9%). Les médias ont représenté la première source d'information (59,5%). Après sensibilisation, 88,8% des sujets qui ne connaissaient pas le médicament générique ont été favorable à son utilisation.Conclusion: Une promotion efficace par une politique d'information soutenue auprès des consommateurs et par des mesures incitatrices à la prescription et à la délivrance du générique par les médecins et les pharmaciens, pourront améliorer l'utilisation de ces médicaments dans notre pays.Key words: Médicament générique, consommateur, perception, Maro

Gravitational Waves from Preheating in Gauss-Bonnet Inflation

We study gravitational wave production in an expanding Universe during the first stages following inflation, and investigate the consequences of the Gauss-Bonnet term on the inflationary parameters for a power-law inflation model with a GB coupling term. Moreover, we perform the analyses on the preheating parameters involving the number of e-folds $N_{pre}$, and the temperature of thermalization $T_{th},$ and show that it's sensitive to the parameters $n$, and $\gamma$, the parameter $\gamma$ is proposed to connect the density energy at the end of inflation to the preheating energy density. We set a correlation of gravitational wave energy density spectrum with the spectral index $n_{s}$ detected by the cosmic microwave background experiments$.$ The density spectrum $\Omega_{gw}$ shows good consistency with observation for $\gamma = 10^{3}$ and $10^{6}$. Our findings suggest that the generation of gravitational waves (GWs) during preheating can satisfy the constraints from Planck's data

Méthodologie générale d’une étude ACP : Généralités, concepts et exemples

Le développement des modèles statistiques des relations quantitatives structure-activité/propriété joue un rôle important dans la conception de nouveaux produits chimiques spécialement pharmaceutiques. La prédiction des propriétés biologiques des produits non testées passe d’abord par une analyse ACP. Il s’agit de l’analyse en composante principale : c’est une méthode basée sur des statistiques descriptives multidimensionnelles permettant de traiter simultanément un nombre quelconque de variables quantitatives. L’objectif est de visualiser et résumer l’information contenue dans les différentes données afin d’avoir une représentation permettant plus facilement l’interprétation. Dans ce papier, nous décrivons des généralités et les principaux concepts et techniques les plus pertinents pour la réalisation d’une étude ACP

Gene expression profiling of mesenteric lymph nodes from sheep with natural scrapie

Background: Prion diseases are characterized by the accumulation of the pathogenic PrPSc protein, mainly in the brain and the lymphoreticular system. Although prions multiply/accumulate in the lymph nodes without any detectable pathology, transcriptional changes in this tissue may reflect biological processes that contribute to the molecular pathogenesis of prion diseases. Little is known about the molecular processes that occur in the lymphoreticular system in early and late stages of prion disease. We performed a microarray-based study to identify genes that are differentially expressed at different disease stages in the mesenteric lymph node of sheep naturally infected with scrapie. Oligo DNA microarrays were used to identify gene-expression profiles in the early/middle (preclinical) and late (clinical) stages of the disease. Results: In the clinical stage of the disease, we detected 105 genes that were differentially expressed (=2-fold change in expression). Of these, 43 were upregulated and 62 downregulated as compared with age-matched negative controls. Fewer genes (50) were differentially expressed in the preclinical stage of the disease. Gene Ontology enrichment analysis revealed that the differentially expressed genes were largely associated with the following terms: glycoprotein, extracellular region, disulfide bond, cell cycle and extracellular matrix. Moreover, some of the annotated genes could be grouped into 3 specific signaling pathways: focal adhesion, PPAR signaling and ECM-receptor interaction. We discuss the relationship between the observed gene expression profiles and PrPSc deposition and the potential involvement in the pathogenesis of scrapie of 7 specific differentially expressed genes whose expression levels were confirmed by real time-PCR. Conclusions: The present findings identify new genes that may be involved in the pathogenesis of natural scrapie infection in the lymphoreticular system, and confirm previous reports describing scrapie-induced alterations in the expression of genes involved in protein misfolding, angiogenesis and the oxidative stress response. Further studies will be necessary to determine the role of these genes in prion replication, dissemination and in the response of the organism to this disease

Characterisation of temperature dependent parameters of multi-quantum well (MQW) Ti/Au/n-AlGaAs/n-GaAs/n-AlGaAs Schottky diodes

Forward and reverse current-voltage (IV) of Ti/Au/n-Al0.33Ga0.67As/n-GaAs/n-Al0.33Ga0.67As multi-quantum well (MQW) Schottky diodes were measured over a range of temperatures from 20 to 400 K by a step of 20 K. The Schottky diodes parameters were then extracted from these characteristics. The Cheung method is used for this purpose, assuming a thermionic conduction mechanism. The extracted ideality factor decrease with increasing temperatures. But their values at low temperatures were found to be unrealistic. In order to explain this uncertainty, three assumptions were explored. Firstly an assumed inhomogeneous barrier height gave better parameters especially the Richardson constant but the ideality factor is still unrealistic at low temperatures. Secondly, by using numerical simulation, it was demonstrated that defects including interface states are not responsible for the apparent unrealistic Schottky diode parameters. The third assumption is the tunnelling mechanism through the barrier in the low temperature range. At these lower temperatures, the tunnelling mechanism was more suitable to explain the extracted parameters values

Histopathological Study of Pure Primary Nephrotic Syndrome in Adolescents and Young Moroccan Adults

Introduction: The primary nephrotic syndrome (PNS) is the most common glomerular nephropathy in children. Its diagnosis and management don’t require histopathological study. It occurs mainly in the form of minimal glomerular lesion and in most cases respond to corticosteroids. The literature on histological lesions of pure PNS in adolescents and young adults is rare. Thus, there are no criteria or recommendations regarding the indications for renal biopsy in patients aged 12-18 years. Methods: This is a retrospective study in which we encountered a total of 386 patients aged 12 to 25 years who were admitted and biopsied at the Nephrology Unit of Ibn Roshd Hospital in Casablanca during the period from January 1st, 2000 to September 30th, 2009 . Patients with pure PNS were 77 (20%), all were included in this study. Results: The average incidence of pure PNS was 7.7 cases per year. The study included 47 males (61%) and 30 females (39%). Patients were sent from all parts of Morocco and the average length of hospital stay was four days. Renal biopsies showed the following morphological lesions: minimal glomerular lesions in 61 cases (79.20%), focal segmental hyalinosis in 7 cases (9.10%), extramembranous glomerulonephritis in 7 cases (9.10%) and 2 cases of renal amyloidosis (2.6%). Conclusion: The minimal glomerular lesions were the most common cause of pure primary nephrotic syndrome in patients aged 12-25 years. Initial renal biopsy may not be indicated in this age group, and an empiric therapeutic trial with corticosteroids may be initially considered.Keywords: Glomerular Disease; Children; Nephrotic Syndrome; Renal Biops

Transmission of sheep-bovine spongiform encephalopathy to pigs

Experimental transmission of the bovine spongiform encephalopathy (BSE) agent has been successfully reported in pigs inoculated via three simultaneous distinct routes (intracerebral, intraperitoneal and intravenous). Sheep derived BSE (Sh-BSE) is transmitted more efficiently than the original cattle-BSE isolate in a transgenic mouse model expressing porcine prion protein. However, the neuropathology and distribution of Sh-BSE in pigs as natural hosts, and susceptibility to this agent, is unknown. In the present study, seven pigs were intracerebrally inoculated with Sh-BSE prions. One pig was euthanized for analysis in the preclinical disease stage. The remaining six pigs developed neurological signs and histopathology revealed severe spongiform changes accompanied by astrogliosis and microgliosis throughout the central nervous system. Intracellular and neuropil-associated pathological prion protein (PrPSc) deposition was consistently observed in different brain sections and corroborated by Western blot. PrPSc was detected by immunohistochemistry and enzyme immunoassay in the following tissues in at least one animal: lymphoid tissues, peripheral nerves, gastrointestinal tract, skeletal muscle, adrenal gland and pancreas. PrPSc deposition was revealed by immunohistochemistry alone in the retina, optic nerve and kidney. These results demonstrate the efficient transmission of Sh-BSE in pigs and show for the first time that in this species propagation of bovine PrPSc in a wide range of peripheral tissues is possible. These results provide important insight into the distribution and detection of prions in non-ruminant animals

Basal and LPS-stimulated inflammatory markers and the course of anxiety symptoms

A cross-sectional relationship between low-grade inflammation -characterized by increased blood levels of Creactive protein (CRP) and pro-inflammatory cytokines- and anxiety has been reported, but the potential longitudinal relationship has been less well studied. We aimed to examine whether basal and lipopolysaccharide (LPS-)induced levels of inflammatory markers are associated with anxiety symptom severity over the course of nine years. We tested the association between basal and LPS-induced inflammatory markers with anxiety symptoms (measured with the Beck's Anxiety Inventory; BAI, Fear Questionnaire; FQ and Penn's State Worry Questionnaire; PSWQ) at 5 assessment waves over a period up nine years. We used multivariate-adjusted mixed models in up to 2867 participants of the Netherlands Study of Depression and Anxiety (NESDA). At baseline, 43.6% of the participants had a current anxiety disorder, of which social phobia (18.5%) was most prevalent. Our results demonstrated that baseline inflammatory markers were significantly associated with several outcomes of anxiety at baseline over nine subsequent years. BAI subscale of somatic (arousal) symptoms of anxiety, and FQ subscale of agoraphobia demonstrated the strongest effects with standardized betacoefficients of up to 0.14. The associations were attenuated by 25%-30% after adjusting for the presence of (comorbid) major depressive disorder (MDD), but remained statistically significant. In conclusion, we found that participants with high levels of inflammatory markers have on average high levels of anxiety consisting of physical arousal and agoraphobia, which tended to persist over a period of nine years, albeit with small effect sizes. These associations were partly driven by co-morbid depression.Stress-related psychiatric disorders across the life spa

Changes in HSP gene and protein expression in natural scrapie with brain damage

Heat shock proteins (Hsp) perform cytoprotective functions such as apoptosis regulation and inflammatory response control. These proteins can also be secreted to the extracellular medium, acting as inflammatory mediators, and their chaperone activity permits correct folding of proteins and avoids the aggregation of anomalous isoforms. Several studies have proposed the implication of Hsp in prion diseases. We analysed the gene expression and protein distribution of different members of the Hsp27, Hsp70, and Hsp90 families in the central nervous system of sheep naturally infected with scrapie. Different expression profiles were observed in the areas analysed. Whereas changes in transcript levels were not observed in the cerebellum or medulla oblongata, a significant decrease in HSP27 and HSP90 was detected in the prefrontal cortex. In contrast, HSP73 was over-expressed in diencephalons of scrapie animals. Western blotting did not reveal significant differences in Hsp90 and Hsp70 protein expression between scrapie and control animals. Expression rates identified by real-time RT-PCR and western blotting were compared with the extent of classical scrapie lesions using stepwise regression. Changes in Hsp gene and protein expression were associated with prion protein deposition, gliosis and spongiosis rather than with apoptosis. Finally, immunohistochemistry revealed intense Hsp70 and Hsp90 immunolabelling in Purkinje cells of scrapie sheep. In contrast, controls displayed little or no staining in these cells. The observed differences in gene expression and protein distribution suggest that the heat shock proteins analysed play a role in the natural form of the disease