Patch testing may help to assess the culpability of a drug in an adverse reaction. Our aim was to study patch testing in severe cutaneous adverse drug reactions (ADRs) (Stevens-Johnson syndrome/toxic ...epidermal necrolysis (SJS/TEN), acute generalized exanthematous pustulosis (AGEP), and other cutaneous ADRs). 59 patients with cutaneous ADRs were included: 22 had SJS/TEN, 14 AGEP, and 23 other cutaneous ADRs. Patients were patch tested with the suspect drug, and with a standard series of drugs. 2 patients among the 22 SJS/TEN cases had a relevant positive test. 7 patients among the 14 AGEP cases had a relevant positive test. 6 patients among the 23 other cutaneous ADRs had a relevant positive test. Our results suggest that patch testing has a weak sensitivity in SJS/TEN and is not appropriate in these diseases. Patch testing seems more adapted to other cutaneous ADRs, such as AGEP, in which the proportion of positive patch tests was significantly higher (p < 0.02). Nevertheless, the difference of sensitivity of patch testing in SJS/ TEN, AGEP or other cutaneous ADRs could be linked not only to the clinical type of eruption, but also to the different spectrum of culprit drugs in each type of eruption.
PaMo 2.0, a type of software, includes a pharmacokinetic model for propofol in the adult. It allows both administration and monitoring of propofol target-controlled infusions. In order to evaluate ...PaMo 2.0, a prospective clinical trial compared, at defined infusion times, predicted and measured plasma propofol concentrations, in 28 patients programmed for hip-replacement surgery. A propofol plasma determination technique had first been validated, including high performance liquid chromatography with fluorescence detection. A statistical analysis based on correlation (r = 0.73), inaccuracy = 29.18 per cent, bias = 11.67 per cent, wobble = 19.15 per cent, and divergence = -0.06 per cent/min calculation, related to this system, has been carried out. PaMo 2.0 under-estimated plasma propofol concentrations. The convergence between predicted and measured propofol concentrations was good and not modified in respect of infusion time. This infusion system is suitable for propofol administration, but the integration of Bayesian pharmacokinetic models would greatly improve propofol plasma concentration estimation and regimen adaptation to each patient.
Abstract 1) Objectives The SUPPLIVER project aims at developing a liver supply system based on cell encapsulation in alginate beads. 2) Material and methods After hepatic cells and alginate were ...mixed, beads were produced by an extrusion method that made the droplets fall in a gelation bath. A bioreactor was designed to host the beads under a fluidized bed perfusion regimen. The biological components were inserted in a complete and safe extracorporeal circuit based on a therapeutic plasmapheresis device. In vitro trials were performed to assess biological functions and both ex vivo and preliminary in vivo studies focused on the system's safety. 3) Results The encapsulation and fluidization processes were validated, showing the maintenance of hepatic functions once spheroids of hepatocytes were formed before encapsulation. The whole extracorporeal circuit was built, including all the monitoring processes for priming and treatment. The first preclinical trials were successful on a sheep model. 4) Conclusion The multidisciplinary consortium succeeded in demonstrating the feasibility of the proposed integrated approach, from cell collection to extracorporeal circuit functions. It led to a promising combined advanced therapies medicinal product, that still needs to be challenged in a large model of hepatic failure.
The number of species (species richness) is certainly the most widely used descriptor of plant diversity. However, estimating richness is a difficult task because plant censuses are prone to ...overlooking and identification errors that may lead to spurious interpretations. We used calibration data from the French ICP-level II plots (RENECOFOR) to assess the magnitude of the two kinds of errors in large forest plots. Eleven teams of professional botanists recorded all plants on the same eight 100-m² plots in 2004 (four plots, eights teams) and 2005 (four plots, nine teams including six from 2004), first independently and then consensually. On average, 15.5% of the shrubs and trees above 2 m were overlooked and 2.3% not identified at the species level or misidentified. On average, 19.2% of the plant species below 2 m in height were overlooked and 5.3% were misidentified and 1.3% were misidentified at the genus level (especially bryophytes). The overlooking rate also varied with plant species, morphological type, plot and team. It was higher when only one botanist made the census. It rapidly decreased with species cover and increased with plot species richness, the recording time of the census in the tree layer and the number of the censuses carried out during the day in the ground layer. Familiarity of the team with the local flora reduced the risk of overlooking and identification errors, whereas training had little impact. Differences in species richness (over space or time) in large plots should be cautiously interpreted, especially when several botanists participate in the survey. In particular, the quality of the data needs to be evaluated using calibration training and, if necessary, may be improved by involving more experienced botanists working in teams and by fixing a minimum recording time.
