Aérosols de médicaments

L\u27aérosolthérapie a bénéficié ces dernières années de progrès technologiques considérables au niveau des générateurs d\u27aérosols. Les aérosols doseurs liquides HFA avec ou sans chambre d\u27inhalation, les aérosols doseurs de poudre ont vu leurs indications respectives précisées. Les systèmes de nébulisation ont également progressé avec notamment l\u27apparition des nébuliseurs à membranes. La nébulisation permet de traiter les formes les plus sévères des maladies repiratoires, asthme, BPCO, mucoviscidose, par les bronchodilatateurs, les corticoïdes, les antibiotiques et la rhDNase I. L\u27utilisation de la nébulisation trouve depuis peu des applications pour le traitement de maladies systémiques telles que le diabète ou l\u27hypertension artérielle pulmonaire. Des perspectives apparaissent également pour la chimiothérapie antitumorale et la vaccination par aérosols. Les conditions optimales de prescription, d\u27administration et de suivi de l\u27aérosolthérapie ont été définies

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Determination of regional lung air volume distribution at mid-tidal breathing from computed tomography: A retrospective study of normal variability and reproducibility

© 2014 Fleming et al.; licensee BioMed Central Ltd. Background: Determination of regional lung air volume has several clinical applications. This study investigates the use of mid-tidal breathing CT scans to provide regional lung volume data.Methods: Low resolution CT scans of the thorax were obtained during tidal breathing in 11 healthy control male subjects, each on two separate occasions. A 3D map of air volume was derived, and total lung volume calculated. The regional distribution of air volume from centre to periphery of the lung was analysed using a radial transform and also using one dimensional profiles in three orthogonal directions.Results: The total air volumes for the right and left lungs were 1035 +/- 280 ml and 864 +/- 315 ml, respectively (mean and SD). The corresponding fractional air volume concentrations (FAVC) were 0.680 +/- 0.044 and 0.658 +/- 0.062. All differences between the right and left lung were highly significant (p < 0.0001). The coefficients of variation of repeated measurement of right and left lung air volumes and FAVC were 6.5% and 6.9% and 2.5% and 3.6%, respectively. FAVC correlated significantly with lung space volume (r = 0.78) (p < 0.005). FAVC increased from the centre towards the periphery of the lung. Central to peripheral ratios were significantly higher for the right (0.100 +/- 0.007 SD) than the left (0.089 +/- 0.013 SD) (p < 0.0001).Conclusion: A technique for measuring the distribution of air volume in the lung at mid-tidal breathing is described. Mean values and reproducibility are described for healthy male control subjects. Fractional air volume concentration is shown to increase with lung size.Air Liquid

PHOSPHORUS-CONTAINING N-METHYLENEAMINE TYPE COMPOUNDS - SYNTHESIS, STRUCTURE, AND REACTIVITY

GALLIOT C, CAMINADE AM, DAHAN F, MAJORAL JP, Schoeller W. PHOSPHORUS-CONTAINING N-METHYLENEAMINE TYPE COMPOUNDS - SYNTHESIS, STRUCTURE, AND REACTIVITY. INORGANIC CHEMISTRY. 1994;33(26):6351-6356.Addition of paraformaldehyde to phosphonodihydrazides PhP(X)(NCH3NH2)(2), 1a (X = S) or 1b (X = O), led to 1,2,4,5,3-perhydrotetrazaphosphorines 4a or 4b and then to stable phosphonodihydrazones PhP(X)(N(CH3)N=CH2)(2), 6a (X = S) or 6b (X = O). Similarly, addition of paraformaldehyde to the hexahydrazino cyclotriphosphazene N3P3(NCH3NH2)(6) afforded a tris(1,2,4,5,3-perhydrotetrazaphosphorine 12, which in turn is transformed to the stable hexakis(N-methyleneamine)cyclotriphosphazine 13 by addition of paraformaldehyde. The crystal and molecular structure of 13 was examined by single crystal X-ray diffraction. Treatment of 6a or 6b with the phosphanylium ion (iPr(2)N)(2)P+CF3SO3-, 15, gave a mixture of bicyclic phosphonium salts 17 and 18 or 19 and 20 respectively. A pyridinium salt 21 was prepared by reacting 6a with trifluoro acetic anhydride in the presence of pyridine. Interaction of the borenium salt (C5H9)(2)B+CF3SO3-, 22, with 6a led to the salt 23 [6a.2B(C5H9)(2).CF3SO3]