Biomedical subjects

F Brion

Publications and source records attributed to F Brion.

At least 19 recordsLinked to original sources

PubMed2003

[Management of the opioid withdrawal in the neonates: French and European survey].

UNLABELLED: Maternal opioid abuse during pregnancy results in 60 to 95% of neonatal withdrawal. The literature review on the evaluation of the severity of the related symptoms and treatments used shows an absence of consensus. MATERIALS AND METHODS: To survey the management of the neonatal withdrawal a questionnaire was sent to French and other European pharmacists. RESULTS: Fifty-eight questionnaires were returned, 37 from France. In 74%, a written protocol about the management of the neonatal withdrawal was available. The severity of the symptoms was assessed using the Finnegan's scale in 55% of the cases and the treatment was a substitute opiate in 72.5%. In 64% of the cases, this drug was an oral morphine solution: a hydrochloride solution in France and a sulfate solution in other E.U countries at the most common dose of 0.5 to 1mg x kg(-1) x d(-1) and 0.24 mg x kg(-1) x d(-1) respectively. DISCUSSION: The solution used in France is contra-indicated in infants less than six months and the presentation is not adapted to this use. CONCLUSION: This morphine survey points out that a preparation intended for infants should be developed and licensed in this indication to improve the use of treatment.

Adult↗

PubMed2003

Extemporaneous (magistral) preparation of oral medicines for children in European hospitals.

AIM: To evaluate methods of preparation of oral medicines in European children's hospitals when drugs prescribed are unlicensed or off-label, and to determine whether such extemporaneously prepared medicines are available as suitable, authorized products in other countries. METHODS: A questionnaire was distributed to 41 hospital pharmacists in 18 European countries, requesting information on the most frequent extemporaneously prepared oral liquid, powder and capsule medicines, and on their formulation and stability. Information was gathered on the availability of suitable authorized forms of these medicines in other European countries, the USA and Australia. RESULTS: 21 questionnaires from 16 countries returned showed that the methods of extemporaneous preparation vary in different European countries with, for example, liquid preparations predominating in England and Sweden, capsules in France and Spain, and powders in Finland and Italy. The top 20 preparations are made in many different strengths and formulations. The same drug may be prepared in liquid, capsule or powder form, depending on the country. Many of the extemporaneous preparations were available as suitable authorized paediatric medicines in other countries. The quality of information available on formulation and stability was limited, and there was concern about the availability and quality of chemical ingredients. CONCLUSION: Preparation of children's oral medicines is subject to much variation in hospitals throughout Europe and there is little harmonization of formulations or information on stability of products. The European Union could be the focus for improving the availability of appropriate authorized medicines for children and ensuring that when extemporaneous preparation is necessary it is of a common high standard.

Administration, Oral↗

PubMed2002

Dual-mode gradient HPLC procedure for the simultaneous determination of chloroquine and proguanil.

In order to assay the antipaludic capsule of the Service de Santé des Armées (SSA), that contains two antimalarial drugs, i.e. chloroquine sulfate (CQS, cp1) and proguanil hydrochloride (PGH, cp5), a HPLC procedure was developed. A reversed-phase ion-pair high-performance liquid chromatography (HPLC) method with an ultraviolet detection at 254 nm was set up and validated. Elution system includes programming of both organic concentration and flow-rate known as 'dual-mode gradient'. This method allows the simultaneous determination of both active compounds and separation of four process related substances. The method is simple, rapid, selective and accurate, and the precision is good with an inter- and intra-assay of <2%. The sensitivity is particularly suitable for pharmaceutical quality control.

Antimalarials↗

PubMed2002

[How patients react when glaucoma is diagnosed?].

PURPOSE: Evaluate the psychological consequences of announcing the diagnosis of glaucoma. MATERIALS AND METHODS: Two hundred patients completed a 20-item questionnaire designed to analyze the context in which glaucoma was discovered and the patients' reaction to this diagnosis. Behavioral modification in patients and their families are specified as well as their perception of the information received. COMMENTS: Most patients had open-angle glaucoma and showed either an anxious or a passive reaction to the announcement of the diagnosis. Severe anxiety led to prescription of minor tranquilizers or antidepressants in 11% of cases. Nearly half of the patients declared that they had modified their behavior after receiving the diagnosis, indicating a need to play an active role in disease management. A large majority of the patients were conscious of the risk of blindness related to glaucoma; however, they did not feel ill but rather handicapped . Most were dissatisfied with the information provided by their doctor and sought other sources of information. CONCLUSION: Announcing a diagnosis of glaucoma is a decisive step in the physician-patient relationship, known to be important in future treatment compliance. Better adapted information with regular reevaluation of the need for additional information is necessary. The psychological impact should be evaluated regularly in order to promote an active role on the part of the patient and avoid a decline in quality of life.

Aged↗

PubMed2001

Separation methods for alkylating antineoplastic compounds.

The separating method for alkylating neoplastic compounds were reviewed based on the classification of the Merck Index (12th Edition). Each section, whenever available or relevant, was subdivided according to the following approach: stability studies, extraction methods, gas chromatography, high-performance liquid chromatography and capillary electrophoresis. At the end of each chapter a separate table summarizing the main characteristics of the separating method were established. In particular LODs and/or LOQs were expressed as quantity to facilitate comparison between methods. This review highlights the problems to measure trace levels of these compounds into biological fluids with respect to their instability, adsorption to glass and plastic or derivatization requirements. Over the last decades, HPLC seems to be more popular than GC for separating the alkylating agents. The development of narrow- or microbore LC coupled to MS is certainly the way to further improve both separation and sensitivity obtained in the different papers surveyed for this review.

Antineoplastic Agents, Alkylating↗

PubMed2001

[Anti-infection prophylaxis after sexual assault. Experience of the Raymond Poincaré-Garches Hospital].

OBJECTIVE: The August 1997 Directive of the Direction of General Health in France extended indications for antiretroviral treatment to risk of HIV exposure by sexual intercourse or syringe sharing. In November 1997, in collaboration with the Hauts-de-Seine MedicoJudiciary center, the Infectious Disease unit of the Raymond Poincaré Garches Hospital established a health care and anti-HIV prophylaxis clinic for victims of sexual assault. We report here the experience in 1998 and 1999. PATIENTS AND METHODS: Between January 1998 and December 1999, 109 victims of sexual assault, 105 women and 4 men, mean age 24.7 +/- 10.6 years attended the clinic. RESULTS: Mean delay from assault to antiretroviral tritherapy (AZT, 3TC, indinavir) was 18.35 +/- 17.39 hours. Mean duration of antiretroviral treatment was 17.4 +/- 11.8 days. HIV screening in perpetrators enabled early interruption of the antiretroviral treatment in 23 cases (21.1%). Sixty-two victims (62%) were still in follow-up at W4/W7. Excellent compliance to tritherapy was observed in these subjects. Clinical intolerance was observed in 46.6% with nausea-vomiting in 91.4% of the cases. Adverse effects led to interruption of indinavir in 5 cases. Initial HIV serology was negative in all cases and no case of HIV seroconversion was observed. Among the 23 known perpetrators, one was HIV-positive with an HIV-RNA at 88,000 copies. Sixty-one victims (55.9%) had been previously vaccinated against the hepatitis B virus; 16 victims were vaccinated after the assault. There were no cases of hepatitis B virus seroconversion. Search for chlamydiae in vaginal secretions was positive in 3 cases and chlamydia serology demonstrated a seroconversion in 1 case. There was no case of syphylitic seroconversion and no case of gonococcal or trichomonas infection. CONCLUSION: The low rate of attendance for follow-up in regards to the gravity of the potential risk of HIV and/or hepatitis B virus transmission and the burden and cost of the antiretroviral treatment highlight the need for better medico-psycho-social support for rape victims. For the victims who attended the clinic, antiretroviral treatment was generally well accepted and well tolerated.

Adolescent↗

PubMed2001

Stability and sterility of meglumine gadoterate injection repackaged in plastic syringes.

The analytical and microbiological stability of meglumine gadoterate (Dotarem) repackaged in polypropylene syringe for 3 months at either +4 degrees C or room temperature was studied. For analytical study: six polypropylene syringes (20 ml) were filled with 15 ml of meglumine gadoterate. Three syringes were stored at 4+/-2 degrees C and three at 25+/-2 degrees C, all syringes were kept upright and protected from daylight. Samples were taken on days 0, 6, 14, 30, 45, 60, 75 and 90. Meglumine gadoterate and its degradation product (free Gd3+) concentrations were obtained using a specific HPLC assay. Osmolality and pH determination were made on days 0, 14, 45 and 90. For microbiological study: 28 plastic syringes (5 ml) were filled with 2.5 ml of meglumine gadoterate. Syringes were stored at 25+/-2 degrees C and protected from daylight. At each day of analysis (0, 15, 35, 45, 60, 75 and 90), four syringes were tested as described in European Pharmacopoeia. After 90 days the concentration of gadoterate remained unchanged and no free Gd3+ were detected. The injectable solution of this gadolinium contrast agent was sterile according to European Pharmacopoeia guidelines. The meglumine gadoterate repackaged in polypropylene syringe was stable for 3 months at all the temperatures studied.

Contrast Media↗

PubMed2001

Quantitative determination of fat emulsion using 1,6-diphenyl-1,3,5-hexatriene as fluorescence probe: application to the compounding of all-in-one parenteral nutrition admixtures.

The potential contamination of binary bags by traces of fat emulsion stemmed from ternary bags prepared just before, led us to determine traces of lipids into the line set of the automated compounder MM23. Diphenylhexatriene (DPH) was chosen as fluorescence probe due to its strong fluorescence enhancement in a lipid environment. Optimization of experimental conditions (i.e. DPH amounts, pH of fat emulsion samples, ultrasounds use, light, temperature and contact duration) for fluorescence measurement and validation of analytical method were performed. This method was linear over 0.5-8.0 mg l(-1) (r=0.999) of fat emulsion. The intra-day and inter-day precisions were inferior to 2% for the 2.0 and 8.0 mg l(-1) standards. Under optimized conditions, the detection limit and quantitation limit were 0.10 and 0.29 mg l(-1) of lipids respectively. Compared to the colorimetric method using sodium dichromate, it is at least 100 times more sensitive. The proposed method permitted to rapidly measure fat emulsion traces in automated compounder line set for parenteral nutrition solutions and thus, to assess the risk of contamination of binary bags by lipids. At last, this method was shown to be conveniently applied to the analysis of fat emulsion in the final total parenteral nutrition bag.

Diphenylhexatriene↗

PubMed2001

[Assessment of the use of aminoglycosides at a pediatrics hospital].

MATERIALS AND METHODS: Three surveys were successively carried out regarding aminoglycoside use: one analysis of amikacine prescriptions in the most prescribing clinical wards and two surveys among nurses and physicians respectively on prescribing, administering and monitoring aminoglycosides. RESULTS: On 43 amikacine prescriptions analyzed in a month, one daily dose infusion in 30 minutes was observed in most of the patients (70%), doses and indications matched most often the official license. Half of patients treated for more than five days had no drug level monitoring. Sample collection by nurses was very erratic making results obtained not interpretable. CONCLUSION: Subsequently, guidelines regarding aminoglycoside use were designed by the interest group, approved by the drug committee and sent to all hospital prescribers and nurses.

Adolescent↗

PubMed2001

[Familial orthochromatic leukodystrophy: clinicopathological study of two cases].

This paper reports the clinico-pathological data in a French family with orthochromatic leukodystrophy. The parents were first cousins and had seven children. Among those, two sisters and one brother presented with neurological signs, with onset around the 5(th) decade, including a dementing syndrome of frontal type, a tetrapyramidal syndrome, seizures, and, in one sibling, a cerebellar syndrome. CT scan or MRI showed diffuse involvement of the white matter. The neurological signs worsened progressively leading to death within 11 and 22 months. Neuropathological examination was performed in two cases. It revealed characteristic orthochromatic leukodystrophy. In one case, the presence of pigmented macrophages and astrocytes was suggestive of Van Bogaert and Nyssen disease. However there were some atypical features including the absence of pigmented cells in the second case whose clinical course was shorter, and the cavitary appearance of the white matter changes with a relative increase in the number of oligodendrocytes raising the issue of a possible link between this condition and cavitary orthochromatic leukodystrophies.

Aged↗

PubMed2001

Frequency of bone lesions: an inadequate criterion for gunshot wound diagnosis in skeletal remains.

A retrospective study was carried out on 130 fatalities due to gunshot wounds to determine whether the combined absence of bone damage and projectile in a skeleton is sufficient to eliminate a diagnosis of gunshot wound. Our findings showed that bone lesions were present in about 90% of the cases and were associated with intracorporeal projectile(s) in about 70% of the cases. The presence or absence of bone lesions seemed independent of the gun characteristics, the shot conditions, and the type of death. The cause of death was predominantly brain injury in cases with bone lesions whereas thoracic, abdominal, and peripheral vascular causes were more frequently encountered in cases without bone damage. We concluded that the combined absence of bone lesions and intracorporeal projectile (about 5% in our series) cannot exclude a diagnosis of death secondary to gunshot wounds.

Adolescent↗

PubMed2000

A vortex-bowl disk atomizer system for the production of alginate beads in a 1500-liter fermentor.

Using a model system, a concept for the immobilization of microbial cultures within alginate beads directly in a 1500-L fermentor with a height to diameter ratio of 1.85 is described. The system is comprised of a 60-cm diameter bowl fixed to the top of an agitation shaft, where calcium-ion-rich media is continuously recirculated from the bulk solution to the bowl. The rotation of the shaft and bowl creates a climbing film (vortex) of solution. An atomizing disk centrally recessed within the bowl sprays an alginate solution into the climbing film where the droplets harden into beads. The effect of heat treatment on the alginate solution on resulting bead properties was examined. The sterilization operation did not appear to have a major effect on the alginate bead mechanical properties of firmness and elasticity which was much more a function of alginate concentration. Beads of various sizes were produced by the unit. The system was characterized by the dimensionless numbers Reomega = (omega x rho x D(2))/mu and ReQ = (Q x rho)/(mu x D). At Reomega and ReQ values less than 500 and 0.15, respectively, the mechanism was direct drop. Parent droplets followed by satellite droplets were observed. When either the flow rate or speed was increased, filaments formed predominantly, which was unwanted in this system because filament breakdown into smaller droplets does not occur due to the proximity of the disk to the climbing film in the bowl. This system could be applied to the immobilization of microorganisms, as well as plant or animal cell cultures, and for other sizes or fermentors. The overflow from the bowl carries the gellified beads into the bulk solution where immobilized cells could act upon the fermentation media.

Alginates↗

PubMed2000

Quantitative high-performance liquid chromatographic determination of acrolein in plasma after derivatization with Luminarin 3.

A rapid, sensitive and specific high-performance liquid chromatographic method for the quantification of acrolein (1), one of the toxic metabolites of oxazaphosphorine alkylating agents (cyclophosphamide and ifosfamide) was developed. Condensation of acrolein with Luminarin 3 afforded a fluorescent derivative that could be specifically detected and quantified. Chromatographic conditions involved a C18 RP column Uptisphere and a gradient elution system to optimize resolution and time analysis. The method showed high sensitivity with a limit of detection of 100 pmol/ml and a limit of quantification of 300 pmol/ml. This technique is particularly suitable for pharmacokinetic studies on plasma of oxazaphosphorine-receiving patients.

Acrolein↗

PubMed2000

Two-step purification method of vitellogenin from three teleost fish species: rainbow trout (Oncorhynchus mykiss), gudgeon (Gobio gobio) and chub (Leuciscus cephalus).

A two-step purification protocol was developed to purify rainbow trout (Oncorhynchus mykiss) vitellogenin (Vtg) and was successfully applied to Vtg of chub (Leuciscus cephalus) and gudgeon (Gobio gobio). Capture and intermediate purification were performed by anion-exchange chromatography on a Resource Q column and a polishing step was performed by gel permeation chromatography on Superdex 200 column. This method is a rapid two-step purification procedure that gave a pure solution of Vtg as assessed by silver staining electrophoresis and immunochemical characterisation.

Animals↗

PubMed2000

[Pediatric drug preparations in French hospitals. Pediatric Group of the French Clinical Pharmacy Society].

AIMS: Drug formulations that are specifically intended for pediatric use have not been widely developed in France and do not adequately meet therapeutic needs, particularly as regards hospital requirements. A multicenter study was therefore carried out to evaluate the situation. MATERIALS AND METHODS: A questionnaire was sent out in June 1998 to all French university hospital pharmacies and also to those public and private hospitals known to be involved in pediatric care. Of the 78 questionnaires mailed, 63 answers were received. The information requested concerned all the drug formulations prepared in 1997. RESULTS: Ten out of the 63 hospitals that replied stated that the questionnaire was not relevant in their particular case. Fifty-three answers were therefore evaluated, i.e., corresponding to data from 35 university hospitals, 15 public general hospitals, and three private hospitals. For 7,022 pediatric beds, 1,155,544 units were prepared consisting of 968,520 capsules prepared from 220 active substances, 33,493 liquid preparations for oral intake, 87,592 parenteral nutrition bags, 48,225 injectable antibiotic drugs, 10,663 injectable anticancer agents, and 7,051 miscellaneous sterile preparations. The most frequently prescribed active substances were, in decreasing order of importance, as follows: diphemanil, captopril, fludrocortisone, ranitidine, spironolactone, and ursodesoxycholic acid. A marked heterogeneity was displayed in galenic forms and drug dosages. CONCLUSION: In conclusion, this study has shown the most commonly prescribed drugs and the most frequently prepared dosages for pediatric use. Drug manufacturing companies may find it an useful source of information on the limited pediatric market; it may also encourage pediatricians to homogenize and optimize their therapeutic strategies, and pharmacists to establish specific quality-control procedures. The authors recommend that national guidelines be set up, and it is suggested that the health authorities could participate in organizing the means whereby drugs for pediatric use are made more readily available.

Chemistry, Pharmaceutical↗

PubMed2000

Postoperative death and malpractice suits: is autopsy useful?

This report demonstrates the extremely high yield of autopsies performed in the case of postoperative death with suspicion of malpractice. They frequently identified undetected complications. They could also suggest faulty or negligent practice that would otherwise go unrecognized. This report supports the widespread use of autopsies to investigate perioperative death.

Adult↗

PubMed2000

Neuronal apoptosis in human immunodeficiency virus infection.

Neuronal apoptosis has been shown to occur in HIV infection by a number of in vivo and in vitro studies, however, the cause of neuronal damage in AIDS is still unclear and its relationships with the cognitive disorders characteristic of HIV dementia remain a matter of debate. In this review, based on our experience, we analyse the techniques used to identify neuronal apoptosis on post-mortem AIDS brains and describe the relationships of neuronal apoptosis with the stage of disease, a history of HIV-dementia, the degree of productive HIV infection, microglial activation, blood-brain barrier involvement and axonal damage. We conclude that the severity of neuronal apoptosis in the cerebral cortex correlates with the presence of cerebral atrophy, but not with the cognitive disorders. There is no global quantitative correlation between neuronal apoptosis and HIV encephalitis, microglial activation or axonal damage. However we found some topographical correlation between these changes. We conclude that neuronal apoptosis and consequent neuronal loss, in HIV infected patients, are probably not related to a single cause. It seems likely that microglial activation, directly or indirectly related to HIV infection of the CNS, plays a major role in its causation possibly through the mediation of oxidative stress. Axonal damage, either secondary to microglial activation, or to the intervention of systemic factors may also contribute to neuronal apoptosis.

AIDS Dementia Complex↗

PubMed2000

[Efficacity of antiseptic products].

Chemical antiseptics are used in specified conditions. This work studied the actual standards to evaluate the activity of antiseptics. Afterward, the main indications of antiseptics are summarized.

Anti-Bacterial Agents↗