Mise en œuvre de procédures d’hygiène et de contrôles physiques et microbiologiques d’environnement au sein d’une unité de radiopharmacie

Preparation of radiopharmaceuticals for injection involves compliance with the regulations for pharmaceutical drugs and radionuclides. The microbiological quality must be ensured, radiation exposure limited, and radioactive contamination of personnel and the environment prevented. Based on work concerning compliance and in accordance with changes in recent regulations, the facilities of the radiopharmacy department of the Louis Mourier Hospital have been optimized. Physical and microbiological controls of equipment and facilities have been implemented to monitor workstations and their environment with respect to microbiological quality. Three hygiene guidelines have also been implemented: improving hygiene practices, personal clothing, practical training on hygiene and its evaluation.     

Retinal drug targets

Retinal effects of systemically administered drugs are rare due to the hematoretinal barriers that protect the retina from circulating active principles. However, some compounds may have direct or indirect toxic effects on the retina through direct interaction with a specific receptor or due to their accumulation within pigment of uveal cells. In the latter case, toxicity is dose-dependent and may be observed years after cessation of medication, as observed with antimalarial drugs. Anti-infective and anti-inflammatory agents, particularly glucocorticoids, are currently injected peri- or intraocularly. The mechanisms and the exact toxicity of glucocorticoids on the retina remain poorly understood. More recently, anti-VEGF has been specifically developed for the treatment of retinal diseases. However, the long-term blockade of VEGF on normal retinal physiology should be determined taking into account VEGF and VEGF receptors expression in the normal and pathologic retina. Whilst enormous advances are made in the treatment of retinal diseases, basic research is still required to define more accurately the molecular targets of drugs to improve their benefits and reduce their potential side effects.     

Efficacity of rituximab in hemolytic anemia with cold autoantibodies case

Introduction

Autoimmune hemolytic anemia with cold autoantibodies or cold agglutinin disease is a rare chronic disorder in which no treatment has, until now, evidence of its effectiveness.

Clinical case

We report a patient who successfully responded to rituximab for a cold agglutinin disease refractory to conventional therapy with very good tolerance and a complete remission.

Conclusion

There are only few observations that have been reported in the literature regarding the efficacity of rituximab in the treatment of cold agglutinin disease. This promising therapy could, in the future, constitute a real alternative.     

Dietary flavonoids and human health

Due to antioxidant properties linked to their polyphenolic structure, dietary flavonoids are supposed to protect the organism against deleterious effects of environmental oxidants. Indeed prospective epidemiologic studies on cohorts have shown inverse correlations between consumption of some foods or beverages with high flavonoid content, (especially flavanols and anthocyanins), and coronary stroke mortality or prevalence of neurodegenerative diseases including Alzheimer's and Parkinson's diseases. These include red wine, some grape juices, red fruits, tea and cocoa, The hypothesis of cause effect relationship between dietary flavonoid intake and observed protection is further supported by several short term controlled randomised clinical trials. However composition of ingested food or beverage is complex and poorly defined, especially their content in different flavonoids. In addition, knowledge on bioavailability of these compounds and their fate in the organism is still limited. The best documented effect is protection or restoration of the vascular endothelium function, principally involving nitric oxide (*NO). It is not established that ingested flavonoids produce a direct antioxidant effect in vivo. By contrast, at the cell level, some flavonoids can modify protein kinases mediated signal transmission, thereby inducing antioxidant and anti-inflammatory genes expression, and, vice versa, inhibiting oxidant and inflammatory gene expression. Presently available information and the important health challenge justify enhanced research in the field.