Administrations parentérales en unité d hématologie soins intensifs (incompatibilités physico-chimiques et optimisations)

Chaque médicament possède des caractéristiques physico-chimiques propres du fait de son principe actif et de ses excipients. Cet aspect est particulièrement important s agissant des spécialités à usage parentéral. La question du risque d incompatibilité physico-chimique (IPC) se pose dès lors qu il y a possibilité de contact entre deux spécialités. OBJECTIFS : Observer les pratiques infirmières et évaluer l ampleur du phénomène IPC au sein de l unité de soins intensifs d hématologie de Grenoble. Proposer une aide à la prévention du risque IPC. MATÉRIELS & MÉTHODES : Observation des pratiques infirmières (préparations et administrations des injectables) pendant 2 mois et comparaison aux références à disposition. Relevé des médicaments les plus utilisés et construction de fiches de propriétés physico-chimiques et de compatibilité. Croisement de ces données pour la réalisation d une matrice de compatibilité adaptée aux besoins de l unité. Etude de l ensemble des prescriptions sur une journée (modalités de préparation et d administration, chronologie) : identification des situations à risque. RÉSULTATS : 174 combinaisons différentes médicament-médicament ont été étudiées en 24h, dont 21 (12%) étaient incompatibles. Les IPC ont concerné à 58% des médicaments passés sur 24h. Plusieurs propositions ont été faites pour réduire le risque IPC dont la séparation des médicaments acides et basiques, le recours à la VVC double et l isolement de la nutrition parentérale.Each drug has self physical and chemical properties because of its active molecule and its excipients. This is particularly relevant talking about parenteral drugs. Any contact between two drugs makes the physicochemical incompatibility risk become real. AIMS : This study will observe the nurse practices and habits and will evaluate the extent of the compatibility problem in the intensive care unit of hematology of Grenoble. Finally, in order to help reducing the compatibility risk, several solutions will be proposed. MATERIALS & METHODS : Observation of preparation and administration habits during two months and comparison of nurse habits versus references. Listing of the most utilized drugs and construction of physicochemical properties and compatibilities forms. Compatibility matrix based on the whole data collected is realized in order to match the unit needs. Finally, a whole day of prescriptions is chosen arbitrarily and investigated so as to identify situations at risk. RESULTS : 174 different combinations of drug have been noted during a period of 24 hours, 21 of them were incompatible (12%). Drugs administered on 24 hours were involved in about 58% of the incompatibilities recorded. Several answers have been proposed to reduce the incompatibility risk like separating acid and basic drugs, using double lumen catheter or isolating parenteral nutrition.GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF

Hybrid thermochemical cycles for low-grade heat storage and conversion into cold and / or power

International audienceIn order to recover low grade heat (available at temperatures under 250 °C) provided for instance by an industrial plant or solar energy, innovative thermodynamic cycles are investigated. These cycles are based on the hybridization of a solid/gas chemical sorption cycle (thermochemical cycle) with a power cycle (Organic Rankine Cycle (ORC)), they enable converting a low grade heat input into cold and / or power while providing an intrinsic energy storage feature. Four hybrid configurations are considered, a thermodynamic analysis allows comparing their performances with those of existing ORC through several criteria: energy and exergy efficiencies, specific exergy output and power production ratio. For each of the five systems, potential applications, advantages and weaknesses are summarized

PHENOPSIS DB: an Information System for Arabidopsis thaliana phenotypic data in an environmental context

<p>Abstract</p> <p>Background</p> <p>Renewed interest in plant × environment interactions has risen in the post-genomic era. In this context, high-throughput phenotyping platforms have been developed to create reproducible environmental scenarios in which the phenotypic responses of multiple genotypes can be analysed in a reproducible way. These platforms benefit hugely from the development of suitable databases for storage, sharing and analysis of the large amount of data collected. In the model plant <it>Arabidopsis thaliana</it>, most databases available to the scientific community contain data related to genetic and molecular biology and are characterised by an inadequacy in the description of plant developmental stages and experimental metadata such as environmental conditions. Our goal was to develop a comprehensive information system for sharing of the data collected in PHENOPSIS, an automated platform for <it>Arabidopsis thaliana </it>phenotyping, with the scientific community.</p> <p>Description</p> <p>PHENOPSIS DB is a publicly available (URL: <url>http://bioweb.supagro.inra.fr/phenopsis/</url>) information system developed for storage, browsing and sharing of online data generated by the PHENOPSIS platform and offline data collected by experimenters and experimental metadata. It provides modules coupled to a Web interface for (i) the visualisation of environmental data of an experiment, (ii) the visualisation and statistical analysis of phenotypic data, and (iii) the analysis of <it>Arabidopsis thaliana </it>plant images.</p> <p>Conclusions</p> <p>Firstly, data stored in the PHENOPSIS DB are of interest to the <it>Arabidopsis thaliana </it>community, particularly in allowing phenotypic meta-analyses directly linked to environmental conditions on which publications are still scarce. Secondly, data or image analysis modules can be downloaded from the Web interface for direct usage or as the basis for modifications according to new requirements. Finally, the structure of PHENOPSIS DB provides a useful template for the development of other similar databases related to genotype × environment interactions.</p

Stockage thermochimique inter saisonnier : caractérisation des transferts de masse au sein d'un sel réactif

National audienceCet article présente la caractérisation des transferts de masse au sein d'un sel réactif (cinétique de réaction, perméabilité du lit de sel, …) destiné au stockage thermochimique inter saisonnier, dans le but d'optimiser à la fois la densité énergétique du lit de sel et sa perméabilité (caractéristiques qui ont des évolutions antagonistes). Un modèle et une expérimentation ont donc été réalisées autour du couple SrBr 2 /H 2 O et leurs résultats ont été comparés

Substantially improved pharmacokinetics of recombinant human butyrylcholinesterase by fusion to human serum albumin

<p>Abstract</p> <p>Background</p> <p>Human butyrylcholinesterase (huBChE) has been shown to be an effective antidote against multiple LD₅₀of organophosphorus compounds. A prerequisite for such use of huBChE is a prolonged circulatory half-life. This study was undertaken to produce recombinant huBChE fused to human serum albumin (hSA) and characterize the fusion protein.</p> <p>Results</p> <p>Secretion level of the fusion protein produced <it>in vitro </it>in BHK cells was ~30 mg/liter. Transgenic mice and goats generated with the fusion constructs expressed in their milk a bioactive protein at concentrations of 0.04–1.1 g/liter. BChE activity gel staining and a size exclusion chromatography (SEC)-HPLC revealed that the fusion protein consisted of predominant dimers and some monomers. The protein was confirmed to have expected molecular mass of ~150 kDa by Western blot. The purified fusion protein produced <it>in vitro </it>was injected intravenously into juvenile pigs for pharmacokinetic study. Analysis of a series of blood samples using the Ellman assay revealed a substantial enhancement of the plasma half-life of the fusion protein (~32 h) when compared with a transgenically produced huBChE preparation containing >70% tetramer (~3 h). <it>In vitro </it>nerve agent binding and inhibition experiments indicated that the fusion protein in the milk of transgenic mice had similar inhibition characteristics compared to human plasma BChE against the nerve agents tested.</p> <p>Conclusion</p> <p>Both the pharmacokinetic study and the <it>in vitro </it>nerve agent binding and inhibition assay suggested that a fusion protein retaining both properties of huBChE and hSA is produced <it>in vitro </it>and <it>in vivo</it>. The production of the fusion protein in the milk of transgenic goats provided further evidence that sufficient quantities of BChE/hSA can be produced to serve as a cost-effective and reliable source of BChE for prophylaxis and post-exposure treatment.</p

CC9 Livestock-Associated Staphylococcus aureus Emerges in Bloodstream Infections in French Patients Unconnected With Animal Farming

We report 4 bloodstream infections associated with CC9 agr type II Staphylococcus aureus in individuals without animal exposure. We demonstrate, by microarray analysis, the presence of egc cluster, fnbA, cap operon, lukS, set2, set12, splE, splD, sak, epiD, and can, genomic features associated with a high virulence potential in human

Is there evidence for an effect of antidepressant drugs on immune function?

Chapitre 15International audienceDepression is a complex disease which is likely to involve several pathophysiological pathways. There is clear evidence that depression is associated with neurochemical and neuroendocrine alterations. Reduced activity of the serotoninergic (5-HT) and noradrenergic (NA) central systems are observed in a majority of patients with major depression (Garver & Davis, 1979). Depressed patients usually also exhibit an alteration of the hypothalamus-pituitary-adrenal (HPA) axis activity characterized by an hyperproduction of corticotropin-releasing hormone (CRH), which stimulates adrenocorticotropic hormone (ACTH) and cortisol release (Holsboer, Bardeleben, Gerken, Stalla, & Muller, 1984). Therefore, the biochemical activity of most antidepressants, including selective 5-HT reuptake inhibitors, monoamine oxidase inhibitors, and tricyclic antidepressants, has been assessed on the basis of their ability to reverse the alterations of monoamine and/or HPA axis activities (Hollister, 1986). However, the metabolic activity of these drugs is not necessarily related directly to their clinical efficacy (Barden, Reul, & Holsboer, 1995; Blier & de Montigny, 1994). Despite repeated attempts, the neuro-hormonal abnormalities observed in depression have never been shown to predict therapeutic response, nor can they account for the symptomatic profile of the patients. Furthermore, depletion of 5-HT or NA in healthy individuals does not induce clinically significant depressive symptomatology (Young, Smith, Pihl, & Erwin, 1985). In addition, there are also some atypical antidepressants with known experimental and clinical therapeutic effects, but devoid of the classic antidepressant actions on central monoamine activity (Guelfi, 1992; Van Riezen & Leonard, 1990)

Is there evidence for an effect of antidepressant drugs on immune function?

National audienc

Optimisation géométrique dérivée de l approche constructale pour réacteurs thermochimiques sous rayonnement solaire concentré

Ce travail porte sur l optimisation de réacteurs thermochimiques fonctionnant sous rayonnement solaire concentré. Un modèle simplifié, dérivant de l approche constructale, est développé, de façon à étudier l influence de la géométrie (configuration, facteur de forme) sur les performances du réacteur, et définir ainsi sa forme optimale. Une étude de sensibilité permet d analyser l influence des paramètres opérationnels sur la forme optimale et sur l efficacité maximale du réacteur. Ce modèle conduit à la définition de configurations innovantes de réacteurs thermochimiques, de haute efficacité : un réacteur multi-cavité et un réacteur cavité à volume de réactif (ou à puits de chaleur) variable. La validité du modèle simplifié est ensuite vérifiée, par comparaison avec les résultats d une simulation numérique 2D. Enfin, la méthodologie est appliquée à la conception optimale d un réacteur appliqué à la production de combustible solaire.This work aims to optimize thermochemical reactor driven by concentrated solar radiation. The definition of a simplified model, deriving from the constructal approach, allows to study the influence of the geometry and shape factor variation on the reactor performances and so to find the optima reactor shape. The influence of the operating parameters on the optimal geometry and on the maximal reactor efficiency is then studied. Starting from the simplified model, the limiting effects are pointed out, and new reactor configurations, at high performance, are proposed. The validity domain of the simplified model is defined by comparing the results with 2D numerical simulations. The model is then used to optimize a thermochemical reactor, applied to the production of solar fuels.PERPIGNAN-BU Sciences (661362101) / SudocSudocFranceF