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991.
Variability of voriconazole plasma levels measured by new high-performance liquid chromatography and bioassay methods 下载免费PDF全文
Pascual A Nieth V Calandra T Bille J Bolay S Decosterd LA Buclin T Majcherczyk PA Sanglard D Marchetti O 《Antimicrobial agents and chemotherapy》2007,51(1):137-143
Voriconazole (VRC) is a broad-spectrum antifungal triazole with nonlinear pharmacokinetics. The utility of measurement of voriconazole blood levels for optimizing therapy is a matter of debate. Available high-performance liquid chromatography (HPLC) and bioassay methods are technically complex, time-consuming, or have a narrow analytical range. Objectives of the present study were to develop new, simple analytical methods and to assess variability of voriconazole blood levels in patients with invasive mycoses. Acetonitrile precipitation, reverse-phase separation, and UV detection were used for HPLC. A voriconazole-hypersusceptible Candida albicans mutant lacking multidrug efflux transporters (cdr1Delta/cdr1Delta, cdr2Delta/cdr2Delta, flu1Delta/flu1Delta, and mdr1Delta/mdr1Delta) and calcineurin subunit A (cnaDelta/cnaDelta) was used for bioassay. Mean intra-/interrun accuracies over the VRC concentration range from 0.25 to 16 mg/liter were 93.7% +/- 5.0%/96.5% +/- 2.4% (HPLC) and 94.9% +/- 6.1%/94.7% +/- 3.3% (bioassay). Mean intra-/interrun coefficients of variation were 5.2% +/- 1.5%/5.4% +/- 0.9% and 6.5% +/- 2.5%/4.0% +/- 1.6% for HPLC and bioassay, respectively. The coefficient of concordance between HPLC and bioassay was 0.96. Sequential measurements in 10 patients with invasive mycoses showed important inter- and intraindividual variations of estimated voriconazole area under the concentration-time curve (AUC): median, 43.9 mg x h/liter (range, 12.9 to 71.1) on the first and 27.4 mg x h/liter (range, 2.9 to 93.1) on the last day of therapy. During therapy, AUC decreased in five patients, increased in three, and remained unchanged in two. A toxic encephalopathy probably related to the increase of the VRC AUC (from 71.1 to 93.1 mg x h/liter) was observed. The VRC AUC decreased (from 12.9 to 2.9 mg x h/liter) in a patient with persistent signs of invasive aspergillosis. These preliminary observations suggest that voriconazole over- or underexposure resulting from variability of blood levels might have clinical implications. Simple HPLC and bioassay methods offer new tools for monitoring voriconazole therapy. 相似文献
992.
993.
Joensuu H De Braud F Grignagni G De Pas T Spitalieri G Coco P Spreafico C Boselli S Toffalorio F Bono P Jalava T Kappeler C Aglietta M Laurent D Casali PG 《British journal of cancer》2011,104(11):1686-1690
Background:Vatalanib (PTK787/ZK 222584) inhibits a few tyrosine kinases including KIT, platelet-derived growth factor receptors (PDGFRs) and vascular endothelial growth factor receptors (VEGFRs). We report efficacy and safety results of vatalanib in advanced gastrointestinal stromal tumour (GIST) resistant to imatinib or both imatinib and sunitinib.Patients and methods:Forty-five patients whose metastatic GIST had progressed on imatinib were enrolled. Nineteen (42.2%) patients had received also prior sunitinib. Vatalanib 1250 mg was administered orally daily.Results:Eighteen patients (40.0%; 95% confidence interval (CI), 25.7-54.3%) had clinical benefit including 2 (4.4%) confirmed partial remissions (PR; duration, 9.6 and 39.4 months) and 16 (35.6%) stabilised diseases (SDs; median duration, 12.5 months; range, 6.0-35.6+ months). Twelve (46.2%) out of the 26 patients who had received prior imatinib only achieved either PR or SD compared with 6 (31.6%, all SDs) out of the 19 patients who had received prior imatinib and sunitinib (P=0.324). The median time to progression was 5.8 months (95% CI, 2.9-9.5 months) in the subset without prior sunitinib and 3.2 (95% CI, 2.1-6.0) months among those with prior imatinib and sunitinib (P=0.992). Vatalanib was generally well tolerated.Conclusion:Vatalanib is active despite its narrow kinome interaction spectrum in patients diagnosed with imatinib-resistant GIST or with imatinib and sunitinib-resistant GIST. 相似文献
994.
Jean-René Lacour Laurent Messonnier Muriel Bourdin 《European journal of applied physiology》2009,106(3):407-413
This report describes the changes in physiological capacity of a heavy-weight rower who obtained seven medals in World Championships
and Olympic Games. The investigation was carried out over the last 6 years of the rower’s international competition career
in comparison with peer champions, and the following 4 years. Over the first period, maximal oxygen uptake () remained above 6 l min−1 which is an outstanding value. The training load measured over the last 18 months of the period increased from 119 to 142 km wk−1 of rowing. Four years after the international competition period, had only declined by 3.6% although the training load had declined by 35%. These data suggest that the ability of this rower
to compete at top level for years was related to ability to maintain an outstanding . Gross efficiency and ability to rely on anaerobic glycolysis did not emerge as relevant factors. 相似文献
995.
Gaetana Di Liberto Laurent Kiger Michael C. Marden Laurent Boyer Florence Canoui Poitrine Marc Conti Marie Georgine Rakotoson Anoosha Habibi Sanam Khorgami Benoit Vingert Bernard Maitre Frederic Galacteros France Pirenne Pablo Bartolucci 《American journal of hematology》2016,91(10):1008-1013
Production of abnormal hemoglobin (HbS) in sickle‐cell disease (SCD) results in its polymerization in deoxygenated conditions and in sickled‐RBC formation. Dense RBCs (DRBCs), defined as density >1.11 and characterized by increased rigidity are absent in normal AA subjects, but present at percentages that vary of a patient to another remaining stable throughout adulthood for each patient. Polymerized HbS has reduced affinity for oxygen, demonstrated by the rightward shift of the oxygen‐dissociation curve, leading to disturbances in oxygen transport. Ninety‐two SCD patients' total RBCs were separated into LightDRBC (LRBC) (d < 1.11 g/mL) and DRBC fractions. Venous blood partial oxygen pressure and RBC‐fraction–deoxygenation and –reoxygenation Hb–oxygen‐equilibrium curves were determined. All patients took a 6‐minute walking test (6MWT); 10 had results before and after >6 months on hydroxyurea. 6MWT time with SpO2 < 88% (TSpO2 < 88) assessed the physiological impact of exertion. Elevated mean corpuscular hemoglobin (Hb) concentrations, decreased %HbF, and 2,3‐bisphosphoglycerates in DRBCs modulated Hb–oxygen affinity. Deoxygenation and reoxygenation Hb–oxygen equilibrium curves differed between normal Hb AA and SS RBCs and between LRBCs and DRBCs, with rightward shifts confirming HbS‐polymerization's role in affinity loss. In bivariate analyses, 50% Hb saturation correlated positively with %DRBCs (P < 0.0001, r2 = 0.34) and negatively with %HbF (P < 0.0001, r2 = 0.25). The higher the %DRBCs, the longer the TSpO288 (P = 0.04). Hydroxyurea was associated with significantly shorter TSpO2 < 88 (P = 0.01). We report that the %DRBCs directly affects SCD patients' SpO2 during exertion; hydroxyurea improves oxygen affinity and lowers the %DRBCs. Am. J. Hematol. 91:1008–1013, 2016. © 2016 Wiley Periodicals, Inc. 相似文献
996.
Lartigue MF Zinsius C Wenger A Bille J Poirel L Nordmann P 《Antimicrobial agents and chemotherapy》2007,51(8):2855-2860
The epidemiology of clavulanic acid-inhibited extended-spectrum beta-lactamases (ESBLs) was investigated among infection-associated enterobacterial isolates at the University Hospital in Lausanne, Switzerland, from January 2004 to June 2005. Out of 57 nonrepetitive ESBL producers (prevalence rate of 0.7%), 45 produced CTX-M-like ESBLs. CTX-M enzymes were mostly from clonally nonrelated Escherichia coli isolates, from urinary infections and community-acquired infections. Pediatric patients (20 out of 57) accounted for a large number of CTX-M producers. CTX-M-15 was the most frequent CTX-M-type enzyme. The plasmid-located bla(CTX-M) genes were associated with either ISEcp1 or ISCR1 insertion sequences. This study is the first published report of CTX-M-type beta-lactamases in Switzerland. 相似文献
997.
Laurent Boyer Patrice Francois Elisabeth Doutre Georges Weil Jose Labarere 《International journal for quality in health care》2006,18(5):359-364
OBJECTIVE: . The aim of this study was to assess clinical staff's opinions on the results of in-patient satisfaction surveys and their use within the quality improvement process. SETTING: The institution is a 2200-bed teaching hospital of tertiary health care employing 8000 professionals. Patient satisfaction surveys are carried out each year using a validated questionnaire mailed to a random sample of patients. The specific results of each department are sent to the medical and paramedical managers. METHODS: We conducted a questionnaire survey on 500 care providers randomly selected in every medical and surgical department. RESULTS: A total of 261 questionnaires were returned and analysed. Overall, 94% of responders had a favourable opinion of the patient satisfaction surveys. They considered that the patient was able to judge hospital service quality, especially in its relational, organizational, and environmental dimensions. The specific results for the department were less well known than the overall hospital results (60 versus 76%). These results were formally discussed in the department according to 40% of responders; 40% declared that these data resulted in improvement actions and considered that they led to modifications in their behaviour with patients. CONCLUSIONS: Despite a declared interest in satisfaction surveys, the results remain underused by hospital staff and insufficiently discussed within teams. 相似文献
998.
Effects of acute dopamine depletion on the electrophysiological properties of striatal neurons 总被引:2,自引:0,他引:2
The striatum, the main input nucleus of basal ganglia, receives a massive innervation from the entire cerebral cortex and is in charge of the detection of behaviorally relevant signals. In turn, via its projections to the output nuclei of basal ganglia, the striatum contributes to the organization of appropriate compartmental responses. Substantia nigra pars compacta dopaminergic neurons project predominantly to the striatum and regulate striatal functions. Implications of dopaminergic receptors on the physiology of striatal neurons are now well documented. By contrast, the effects of acute dopamine depletion on striatal neurons remain poorly explored. Here, the alpha-methyl-para-tyrosine was used to deplete dopamine from rat brain slices. We analyzed the consequences of a alpha-methyl-para-tyrosine treatment on membrane properties of striatal neurons: the medium-sized spiny neurons and the interneurons (GABAergic, cholinergic and NO-synthase). After acute dopamine depletion, medium-sized spiny neurons became more excitable. GABAergic interneurons became less excitable whereas cholinergic cells displayed an increased excitability. NO-synthase-containing interneurons did not show noticeable changes in their excitability. Such membrane properties changes indicate that striatal circuits should undergo major alteration in cortico-basal ganglia information processing. 相似文献
999.
Jér?me Jacques Maude Bouscambert-Duchamp Hélène Moret Jocelyne Carquin Véronique Brodard Bruno Lina Jacques Motte Laurent Andréoletti 《Journal of clinical virology》2006,35(4):463-466
BACKGROUND: Human rhinoviruses and enteroviruses (Picornaviridae) are suspected to be major viral etiological causes of bronchiolitis in infants. OBJECTIVES: In the present study, we assessed the potential role of the respiratory picornaviruses as causative agents of bronchiolitis in French infants. STUDY DESIGN: From September 2001 to June 2002, we prospectively selected 192 infants < or =36 months of age and hospitalized for acute bronchiolitis. The detection of common respiratory viruses (respiratory syncytial virus, influenza virus A and B, parainfluenza virus 1, 2, 3 and adenovirus) was performed using classical immunofluorescence antigen and cell-culture detection assays on nasopharyngeal aspirates whereas the detection of human metapneumovirus (HMPV) was performed by a real-time RT-PCR assay. The presence of rhinovirus and/or enterovirus was assessed in respiratory samples by a picornavirus RT-PCR detection assay followed by a differential Southern blotting procedure. RESULTS: A potential causative virus was detected in 72.5% of the 192 study infants. RSV (30%), rhinovirus (21%), enterovirus (9%), influenza virus A (6%) and human metapneumovirus (4%) were the most frequent causative agents detected. Rhinoviruses or enteroviruses were detected as the only evidence of respiratory viral tract infection in 57 (30%) of 192 infants, whereas rhinovirus or enterovirus occurred in mixed viral infection detected in 25 (13%) of 192 study cases (30% versus 13%, p<10(-3)). CONCLUSIONS: Our data suggest that respiratory picornaviruses are one of the leading etiological causes of bronchiolitis in French infants. These findings highlight the need to implement a rapid picornavirus RT-PCR detection assay for the clinical diagnosis of respiratory infections in pediatric patients with bronchiolitis. 相似文献
1000.
Guillaume Mellon Laurent Rigal Henri Partouche Olivier Aoun Philippe Jaury Nathalie Joannard Jean Paul Guthmann Delphine Cochereau Eric Caumes Francois Bricaire Dominique Salmon-Céron 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2014,25(3):141-146