Third Yearly Activity Report

The calculation work performed during the 3rd project year in WP2 as well as the R&D activities carried out in WP3, WP4 and WP5 are described in this report. In addition, the work dedicated to the project management (WP1) as well as to WP6 regarding the dissemination/communication activities and the education/training program (e.g. the follow-up of the mobility program between different organizations in the consortium, training on simulation tools and activities accomplished by PhD/post-doctoral students) is also reported

Amphibious auditory responses of the American alligator (Alligator mississipiensis)

Animals that thrive both on land and underwater are faced with the task of interpreting stimuli in different media. This becomes a challenge to the sensory receptors in that stimuli (e.g., sound, motion) may convey the same type of information but are transmitted with different physical characteristics. We used auditory brainstem responses to examine hearing abilities of a species that makes full use of these two environments, the American alligator (Alligator mississipiensis). In water, alligators responded to tones from 100 Hz to 2,000 Hz, with peak sensitivity at 800 Hz. In air, they responded to tones from 100 Hz to 8,000 Hz, with peak sensitivity around 1,000 Hz. We also examined the contribution to hearing of an air bubble that becomes trapped in the middle ear as the animal submerges. This bubble has been previously implicated in underwater hearing. Our studies show that the trapped air bubble has no affect on auditory thresholds, suggesting the bubble is not an important adaptation for underwater hearing in this species

Does Spinal Surgery in Elderly Patients (Over 80 Years-Old) Lead to More Early Post-Operative Complications Than Lower Limb Prosthetic Surgery?

Purpose: Patients and surgeons may be reluctant on spinal surgery over 80 years old, fearing medical complications despite the possible improvement on quality of life. However, fewer reservations for lower limb prosthetic surgery (LLPS) seem to be arisen in this population. Is spinal surgery after 80 years-old responsible of more complications than lower limb surgery? Methods: The consecutive files of 164 patients over 80 years that had spinal surgery or LLPS were analyzed. The data collected pre-operatively were demographic, clinical and post-operatively the number and types of medical complications and length of stay. Results: The mean number of medical complications was 1.11 ± 0.6 [0–6] for spinal surgery and 1.09 ± 1.0 [0–3] for LLPS, ( p  = 0,87). The length of stay in orthopedic unit was comparable between the two groups: 10.7 ± 4.9 days [2–36] for SS and 10.7 ± 3.0 days [5–11] for LLPS ( p  = 0,96). Conclusion: The global rate of peri-operative complications and the length of hospital stay were similar between spinal surgery and lower limb prosthetic surgery. These results may be explained by the rising cooperation between geriatric specialist and surgeons and the development of mini-invasive surgical technics, diminishing the early post-operative complication rates

IL CONSENSO INFORMATO NELLA CURA DEL PAZIENTE CON FRATTURA DEL FEMORE

Informed consent is fundamental in the process of care, except in case of urgent, lifesaving treatments. In Italy, the legal sources are the Italian Constitution, the numerous judgments of the courts and the current \u201cCodice di Deontologia medica\u201d. In clinical practice, as in the case of the elderly patient with hip fracture, the physician may encounter problems if the patient is incompetent and without legal representation

Determinants of hydroxychloroquine blood concentration variations in systemic lupus erythematosus.

International audienceBlood concentrations of hydroxychloroquine (HCQ) vary widely among patients with systemic lupus erythematosus (SLE). A pharmacokinetic/pharmacodynamic relationship has been found in different situations, and a very low blood concentration of HCQ is a simple marker of nonadherence to treatment. Therefore, interest in blood HCQ concentration measurement has increased, but little is known about factors that influence blood HCQ concentration variability. This study was undertaken to analyze determinants of blood HCQ concentrations. We conducted a retrospective analysis of patient data, including data from the Plaquenil Lupus Systemic (PLUS) study, to determine the association of epidemiologic, clinical, and biologic factors with blood HCQ concentrations. Data for nonadherent patients (blood HCQ concentration <200 ng/ml) were excluded. To examine homogeneous pharmacologic data, we restricted the analyses of the PLUS data to the 509 SLE patients receiving 400 mg/day. We found no association of ethnicity or smoking with blood HCQ concentrations and no pharmacokinetic drug-drug interaction with antacids or with inhibitors or inducers of cytochrome P450 enzymes. On multivariate analysis, high body mass index (P = 0.008), no treatment with corticosteroids (P = 0.04), increased time between the last tablet intake and measurement of blood HCQ concentrations (P = 0.017), low platelet count (P < 0.001), low neutrophil count (P < 0.001), and high estimated creatinine clearance (P < 0.001) were associated with low blood HCQ concentrations. In 22 SLE patients with chronic renal insufficiency (median serum creatinine clearance 52 ml/minute [range 23-58 ml/minute]) who received 400 mg/day HCQ, the median blood HCQ concentration was significantly higher than that in the 509 patients from the PLUS study (1,338 ng/ml [range 504-2,229 ng/ml] versus 917 ng/ml [range 208-3316 ng/ml]) (P < 0.001). We provide a comprehensive analysis of determinants of blood HCQ concentrations. Because this measurement is increasingly being used, these data might be useful for clinicians