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1.
J Neurooncol ; 153(1): 133-141, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33837880

RESUMEN

PURPOSE: Brain metastases (BM) usually represent a poor prognostic factor in solid tumors. About 10% of patients with renal cancer (RCC) will present BM. Local therapies such as stereotactic radiotherapy (SRT), whole brain radiotherapy (WBRT), and surgery are used to achieve brain control. We compared survival between patients with synchronous BM (SynBM group) and metachronous BM (MetaBM group). METHODS: It is a retrospective study of patients with clear cell renal cell carcinoma (ccRCC) and BM treated with TKI between 2005 and 2019 at the Centre Léon Bérard in Lyon. We collected prognostic factors: The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk score, the TNM stage, the histological subtypes and the Fuhrman grade. Overall survival (OS) was defined from diagnosis of metastatic ccRCC to death. Brain progression-free survival (B-PFS) was defined from focal brain therapy to brain progression or death. RESULTS: 99 patients were analyzed, 44 in the SynBM group and 55 in the MetaBM group. OS in the MetaBM group was 49.4 months versus 19.6 months in the SynBM group, p = 0.0002. The median time from diagnosis of metastasic disease to apparition of BM in the MetaBM group was 22.9 months (4.3; 125.7). SRT was used for 101 lesions (66.4%), WBRT for 25 patients (16.4%), surgery for 21 lesions (13.8%), surgery followed by radiation for 5 lesions (3.3%). B-PFS for all patients was 7 months (IC95% [5.0-10.5]). CONCLUSIONS: Survival of patients with synchronous BM is inferior to that of patients with metachronous BM. Outcome is poor in both cases after diagnosis of BM. Brain screening should be encouraged at time of diagnosis of metastatis in ccRCC.


Asunto(s)
Neoplasias Encefálicas , Carcinoma de Células Renales , Neoplasias Renales , Encéfalo , Neoplasias Encefálicas/secundario , Neoplasias Encefálicas/terapia , Carcinoma de Células Renales/terapia , Humanos , Neoplasias Renales/terapia , Pronóstico , Estudios Retrospectivos
2.
Int J Sports Med ; 39(1): 21-28, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29169189

RESUMEN

The hypothesis that aging and regular physical activity could influence oxidative stress has been studied by comparing antioxidant activities (superoxide dismutase (SOD), glutathione peroxidase (GPX), glutathione reductase (GR), ascorbic acid and α-Tocopherol) and malondialdehyde level (MDA) in four groups: young sedentary (n=15; age: 20.3±2.8 years; YS), young active (n=16; age: 21.4±1.9 years; YA), old sedentary (n=15; age: 65.1±3.5 years; OS) and old active (n=17; age: 67.2±4.8 years; OA). Antioxidant activities and MDA level were assessed at rest and after an incremental exercise. There was no difference in resting antioxidant activities and lipid peroxidation between YS and OS. However, resting SOD and GR activities were higher in YA compared to OA (p<0.01 and p<0.05, respectively) and resting MDA level was higher in OA compared to YA (p<0.01). After exercise, a significant increase in SOD and GPX activities was observed in YS, YA and OA (p<0.01). Likewise, after exercise a significant increase of MDA level in YA, OS and OA (p<0.01) was observed. In addition, the comparison of YA to OA and YS to OA revealed similar antioxidant activities and lipid peroxidation between YS and OA, whereas antioxidant activities were higher in YA compared to OA. These data suggest that beneficial effects of regular physical activity in antioxidant defense and lipid peroxidation damage could be impaired by the aging process and that regular physical activity in older adults could maintain age-related decreases in antioxidant defense.


Asunto(s)
Envejecimiento/fisiología , Ejercicio Físico/fisiología , Estrés Oxidativo/fisiología , Anciano , Ácido Ascórbico/sangre , Dieta , Femenino , Glutatión Peroxidasa/sangre , Glutatión Reductasa/sangre , Humanos , Peroxidación de Lípido , Masculino , Malondialdehído/sangre , Aptitud Física/fisiología , Superóxido Dismutasa/sangre , Adulto Joven , alfa-Tocoferol/sangre
3.
Pharm Res ; 34(9): 1773-1783, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28527126

RESUMEN

PURPOSE: This work focused on the preparation of polycaprolactone based nanoparticles containing indomethacin to provide topical analgesic and anti-inflammatory effect for symptomatic treatment of inflammatory diseases. Indomethacin loaded nanoparticles are prepared for topical application to decrease indomethacin side effects and administration frequency. Oppositely to already reported works, in this research non-invasive method has been used for the enhancement of indomethacin dermal drug penetration. Ex-vivo skin penetration study was carried out on fresh human skin. METHODS: Nanoprecipitation was used to prepare nanoparticles. Nanoparticles were characterized using numerous techniques; dynamic light scattering, SEM, TEM, DSC and FTIR. Regarding ex-vivo skin penetration of nanoparticles, confocal laser scanning microscopy has been used. RESULTS: The results showed that NPs hydrodynamic size was between 220 to 245 nm and the zeta potential value ranges from -19 to -13 mV at pH 5 and 1 mM NaCl. The encapsulation efficiency was around 70% and the drug loading was about 14 to 17%. SEM and TEM images confirmed that the obtained nanoparticles were spherical with smooth surface. The prepared nanoparticles dispersions were stable for a period of 30 days under three temperatures of 4°C, 25°C and 40°C. In addition, CLSM images proved that obtained NPs can penetrate the skin as well. CONCLUSION: The prepared nanoparticles are submicron in nature, with good colloidal stability and penetrate the stratum corneum layer of the skin. This formulation potentiates IND skin penetration and as a promising strategy would be able to decline the side effects of IND.


Asunto(s)
Antiinflamatorios no Esteroideos/administración & dosificación , Portadores de Fármacos/química , Indometacina/administración & dosificación , Nanopartículas/química , Poliésteres/química , Absorción Cutánea , Administración Cutánea , Antiinflamatorios no Esteroideos/farmacocinética , Humanos , Indometacina/farmacocinética , Nanopartículas/ultraestructura , Tamaño de la Partícula , Piel/metabolismo
4.
J Aging Phys Act ; 22(4): 536-42, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24226272

RESUMEN

This comparative study examined the effects of regular low intensity aerobic exercise on oxidative stress markers in older adults. The study was carried out on 15 sedentary subjects (age: 65.1 ± 3.5 years) versus 18 subjects performing fitness exercises (age: 65.8 ± 3.3 years). Before and after an incremental exercise test, oxidative stress markers were assessed. Superoxide dismutase was higher at rest and at the recovery for the physically active subjects compared with sedentary subjects (p < .05). At recovery, glutathione peroxidase and α -Tocopherol increased significantly above the resting values only in the active group (p < .05). Malondialdehyde had increased in both groups (p < .01), associated with a higher level in the sedentary group (p < .05) at the recovery. These data suggest that low intensity aerobic exercise may be useful to prevent the decline of antioxidants linked with aging.


Asunto(s)
Envejecimiento/fisiología , Antioxidantes/metabolismo , Ejercicio Físico/fisiología , Estrés Oxidativo/fisiología , Conducta Sedentaria , Anciano , Biomarcadores/sangre , Prueba de Esfuerzo/métodos , Femenino , Glutatión Peroxidasa/sangre , Humanos , Masculino , Malondialdehído/sangre , Persona de Mediana Edad , Aptitud Física/fisiología , Superóxido Dismutasa/sangre , alfa-Tocoferol/sangre
6.
J Aging Health ; 35(5-6): 430-438, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36342264

RESUMEN

Objectives: To demonstrate the association between the Hospital Frailty Risk Score (HFRS) and 30-day mortality, 30-day hospital readmission and length of stay (LOS) in France. Methods: Logistic regressions were performed using data recorded in the French national health data system (SNDS) for elderly patients (≥75 years old) hospitalized in France in 2017. Results: Over the 1,111,090 patients included, 30-day mortality was associated with the HFRS: adjusted OR (aOR) for an intermediate HFRS (5-15 points) was 1.91 [95% confidence interval (95% IC); 1.87-1.95] and aOR 2.57 [95% IC; 2.50-2.64] for high HFRS (>15 points), as compared to low HFRS (<5 points). LOS >10 days increased with the HFRS (aOR = 1.36 [95% IC; 1.34-1.38] for an intermediate HFRS and aOR 1.51 [95% IC; 1.48-1.54] for a high HFRS). A high HFRS was associated with 30-day hospital readmission (aOR = 1.06 [95% IC; 1.04-1.08]). Discussion: This real-life analysis of in- and out-patient healthcare pathways confirmed the HFRS's ability to predict adverse outcomes, after adjustment on social deprivation.


Asunto(s)
Fragilidad , Humanos , Anciano , Fragilidad/epidemiología , Hospitalización , Tiempo de Internación , Hospitales , Factores de Riesgo , Estudios Retrospectivos
7.
Skin Res Technol ; 18(2): 251-8, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22093093

RESUMEN

BACKGROUND/AIMS: Different models of reconstructed skin are available, either to provide skin wound healing when this process is deficient, or to be used as an in vitro model. Nevertheless, few studies have focused on the mechanical properties of skin equivalent. Indeed, human skin is naturally under tension. Taking into account these features, the purpose of this work was to obtain a cellularized dermal equivalent (CDE), composed of collagen and dermal fibroblasts. METHODS: To counteract the natural retraction of CDE and to maintain it under tension, different biomaterials were tested. Selection criteria were biocompatibility, bioadhesion properties, ability to induce differentiation of fibroblasts into myofibroblasts and mechanical characterization, considering that of skin in vivo. These assays led to the selection of honeycomb of polyester. CDE constructed on this biomaterial was further characterized mechanically using tensile tests. RESULTS: The results showed that mechanical features of the obtained dermal equivalent, including myofibroblasts, were similar to skin in vivo. CONCLUSION: The original model of dermal equivalent presented herein may be a useful tool for clinical use and as an in vitro model for toxicological/pharmacological research.


Asunto(s)
Dermis/fisiología , Fibroblastos/fisiología , Ensayo de Materiales/métodos , Fenómenos Fisiológicos de la Piel , Piel Artificial , Actinas/fisiología , Adhesión Celular/fisiología , Diferenciación Celular/fisiología , Células Cultivadas , Dermis/citología , Estudios de Factibilidad , Fibroblastos/citología , Citometría de Flujo , Humanos , Concentración de Iones de Hidrógeno , Técnicas In Vitro , Poliésteres , Estrés Mecánico , Resistencia a la Tracción/fisiología
8.
Eur J Pharm Sci ; 168: 106082, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34822973

RESUMEN

Skin hyperpigmentation is caused by an excessive production of melanin. Cysteamine, an aminothiol compound physiologically synthetized in human body cells, is known as depigmenting agent. The aim of this study was to evaluate the depigmenting activity and skin penetration of liposome formulations encapsulating cysteamine hydrochloride. First, cysteamine hydrochloride-loaded liposomes were prepared and characterized for their size, polydispersity index, zeta potential and the encapsulation efficiency of the active molecule. The stability of cysteamine hydrochloride in the prepared liposome formulations in suspension and freeze-dried forms was then assessed. The in vitro cytotoxicity of cysteamine and cysteamine-loaded liposome suspensions (either original or freeze-dried) was evaluated in B16 murine melanoma cells. The measurement of melanin and tyrosinase activities was assessed after cells treatment with free and encapsulated cysteamine. The antioxidant activity of the free and encapsulated cysteamine was evaluated by the measurement of ROS formation in treated cells. The ex vivo human skin penetration study was also performed using Franz diffusion cell. The stability of cysteamine hydrochloride was improved after encapsulation in liposomal suspension. In addition, for the liposome re-suspended after freeze-drying, a significant increase of vesicle stability was observed. The free and the encapsulated cysteamine in suspension (either original or freeze-dried) did not show any cytotoxic effect, inhibited the melanin synthesis as well as the tyrosinase activity. An antioxidant activity was observed for the free and the encapsulated cysteamine hydrochloride. The encapsulation enhanced the skin penetration of cysteamine hydrochloride. The penetration of this molecule was better for the re-suspended freeze-dried form than the original liposomal suspension where the drug was found retained in the epidermis layer of the skin.


Asunto(s)
Cisteamina , Liposomas , Animales , Liofilización , Humanos , Ratones , Piel , Absorción Cutánea
9.
Respiration ; 82(6): 501-8, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21934275

RESUMEN

BACKGROUND: Patients with sarcoidosis frequently exhibit exertional dyspnea. Although the functional limitation might be related to ventilatory problems, some patients exhibited exertional dyspnea without significant abnormalities of pulmonary function tests (PFT). Therefore, the mechanisms responsible for exercise intolerance remain unclear. OBJECTIVES: The aim of this retrospective study was to determine the mechanisms responsible for exercise intolerance. METHODS: Cardiopulmonary exercise testing (CPET) was performed in 157 dyspneic sarcoid patients (stage I: 29; stage II-III: 95; stage IV: 33) and VO2 peak was correlated with radiological stage and resting PFT. RESULTS: VO2 peak was decreased in 73% patients, did not differ according to radiological stage and was correlated with VC, FVC, FEV1, TLC and DLCO. FVC was the major significant predictor of VO2 peak explaining 17% of VO2 variation. Among CPET variables, peak heart rate and VE/VO2 at ventilatory threshold explained 22% of VO2 alteration in stage I and stage II-III, and 9% in stage IV. In stage IV, V(D)/V(T) peak explained 41% of VO2 alteration. CONCLUSION: In conclusion, in the lower stages circulatory impairment and impaired heart rate response to exercise are involved in the exercise capacity limitation, whereas in stage IV the ventilatory and gas exchange impairment may be more important. CPET must be performed to accurately characterize the mechanisms responsible for exercise limitation and help the clinician in the management of the disease.


Asunto(s)
Umbral Anaerobio , Disnea/metabolismo , Tolerancia al Ejercicio , Oxígeno/metabolismo , Intercambio Gaseoso Pulmonar , Sarcoidosis/metabolismo , Adulto , Anciano , Disnea/fisiopatología , Prueba de Esfuerzo/métodos , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Descanso , Estudios Retrospectivos , Sarcoidosis/fisiopatología , Índice de Severidad de la Enfermedad , Adulto Joven
10.
J Strength Cond Res ; 25(5): 1393-9, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21358435

RESUMEN

Prediction of time to exhaustion in competitive cyclists from a perceptually based scale. We have tested the validity of the estimated time limit (ETL) scale to predict an exhaustion time (T(lim)) from values stemming from incremental and randomized constant workloads tests on a cycle ergometer. Twenty-five cyclists performed 1 continuous incremental test, 1 discontinuous test with randomized workloads, and 1 constant power output test at 90% of maximal aerobic power (MAP) to exhaustion. Estimated time limits at 90% MAP during the incremental test and the test with randomized workloads were calculated from exponential relationships between power and ETL using the same 4 workloads. Real measured T(lim) during the constant power output test was converted into ETL values (called measured ETL). The differences between the calculated and measured ETLs were examined. Estimated time limits calculated at 90% MAP during the incremental and randomized tests corresponded to 14 minutes 56 seconds and 10 minutes 14 seconds, whereas measured ETL was equal to 11 minutes 19 seconds ± 3 minutes 40 seconds. The results showed a nonsignificant difference between calculated and measured ETLs. However, the mean differences between the measured ETL values during the constant test performed at the same intensity were -1.3 ± 2.9 and 0.3 ± 3.0 for the incremental and the randomized constant workloads tests, respectively. Consequently, the use of ETL calculated at 90% MAP during the test with randomized constant workloads may be preferable to predict the accurate T(lim). Moreover, it would seem that high-level cyclists, who were more consciously attuned to their bodies and their own effort sense, were more accurate in their prediction than low-level cyclists. It is concluded that the randomized constant workloads test that is both shorter and less strenuous would be more convenient for high-level athletes.


Asunto(s)
Ciclismo/fisiología , Prueba de Esfuerzo/métodos , Frecuencia Cardíaca/fisiología , Consumo de Oxígeno/fisiología , Esfuerzo Físico/fisiología , Adulto , Atletas/estadística & datos numéricos , Ergometría , Humanos , Masculino , Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Aptitud Física/fisiología , Valor Predictivo de las Pruebas , Ventilación Pulmonar , Valores de Referencia , Reproducibilidad de los Resultados , Factores de Tiempo , Adulto Joven
11.
J Contemp Brachytherapy ; 13(4): 373-386, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34484351

RESUMEN

PURPOSE: Iodine-125 (125I) brachytherapy (BT) alone for intermediate-risk (IR) prostate adenocarcinoma (PCA) is controversial. The purpose of the study was to investigate potential predictive factors in selected IR-PCA patients treated with BT. MATERIAL AND METHODS: Among 547 patients treated with 125I BT between 2003 and 2013, 149 IR-PCA cases were selected according to NCCN classification after an additional exclusion of patients with prostate specific antigen (PSA) > 15 ng/ml and ISUP group 3. A relapse was defined as a biochemical failure, using ASTRO Phoenix definition, or a relapse identified on imaging. Survival curves were estimated with Kaplan-Meier method. Potential prognostic variables including EAU/ESTRO/SIOG guidelines eligibility criteria were analyzed using univariate and Cox's proportional hazards regression analysis. RESULTS: Of the 149 IR patients, 112 were classified as favorable, with 69 cases eligible to BT according to EAU/ESTRO/SIOG guidelines, and 37 patients were identified as unfavorable as per NCCN. Androgen deprivation therapy (ADT) was applied in 6 patients only. Percentage of positive biopsy cores were ≤ 33% and ≥ 50% for 119 and 11 patients, respectively. With a median follow-up of 8.5 years, 30 patients experienced a relapse. 10-year overall survival, progression-free survival (PFS), and relapse-free survival (RFS) were 84% (95% CI: 75-90%), 66% (95% CI: 56-75%), and 77% (95% CI: 67-84%), respectively. Failure to meet EAU/ESTRO/SIOG criteria was significantly associated with a lower RFS (p = 0.0267, HR = 2.37 [95% CI: 1.10-5.08%]). CONCLUSIONS: Brachytherapy is an effective treatment for selected IR-PCA cases. Patients who were not eligible according to EAU/ESTRO/SIOG guidelines demonstrated a lower RFS.

12.
J Am Med Dir Assoc ; 22(8): 1599-1601, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34197795

RESUMEN

The COVID-19 pandemic has had a major impact on nursing homes (NHs), which were not prepared to manage infections among their at-risk patient populations. In order to comply with the French government's guidelines, we rapidly set up a local support platform (LSP) to help NHs manage their cases of COVID-19. The LSP comprised multidisciplinary decision support, a specialist phone hotline, mobile geriatric medicine teams, and videoconferences on COVID-19. We first quantified the LSP's interventions in 63 local NHs since the start of the first wave of COVID-19 (March 2020): 9 instances of multidisciplinary decision support, 275 calls to the specialist phone hotline, 84 interventions by mobile geriatric medicine teams, and 16 videoconferences. The LSP had been used during and between the first and second waves of the epidemic, and all had evolved to meet the NHs' needs.


Asunto(s)
COVID-19 , Pandemias , Anciano , Retroalimentación , Humanos , Casas de Salud , SARS-CoV-2
13.
Int J Radiat Oncol Biol Phys ; 109(5): 1243-1253, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33186618

RESUMEN

PURPOSE: Prostate bed (PB) irradiation is considered the standard postoperative treatment after radical prostatectomy (RP) for tumors with high-risk features or persistent prostate-specific antigen, or for salvage treatment in case of biological relapse. Four consensus guidelines have been published to standardize practices and reduce the interobserver variability in PB delineation but with discordant recommendations. To improve the reproducibility in the PB delineation, the Francophone Group of Urological Radiotherapy (Groupe Francophone de Radiothérapie Urologique [GFRU]) worked to propose a new and more reproducible consensus guideline for PB clinical target volume (CTV) definition. METHODS AND MATERIALS: A 4-step procedure was used. First, a group of 10 GFRU prostate experts evaluated the 4 existing delineation guidelines for postoperative radiation therapy (European Organization for Research and Treatment of Cancer; the Faculty of Radiation Oncology Genito-Urinary Group; the Radiation Therapy Oncology Group; and the Princess Margaret Hospital) to identify divergent issues. Second, data sets of 50 magnetic resonance imaging studies (25 after RP and 25 with an intact prostate gland) were analyzed to identify the relevant anatomic boundaries of the PB. Third, a literature review of surgical, anatomic, histologic, and imaging data was performed to identify the relevant PB boundaries. Fourth, a final consensus on PB CTV definition was reached among experts. RESULTS: Definitive limits of the PB CTV delineation were defined using easily visible landmarks on computed tomography scans (CT). The purpose was to ensure a better reproducibility of PB definition for any radiation oncologist even without experience in postoperative radiation therapy. CONCLUSIONS: New recommendations for PB delineation based on simple anatomic boundaries and available as a CT image atlas are proposed by the GFRU. Improvement in uniformity in PB CTV definition and treatment homogeneity in the context of clinical trials are expected.


Asunto(s)
Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/radioterapia , Puntos Anatómicos de Referencia/anatomía & histología , Puntos Anatómicos de Referencia/diagnóstico por imagen , Consenso , Humanos , Imagen por Resonancia Magnética , Masculino , Variaciones Dependientes del Observador , Pene/anatomía & histología , Pene/diagnóstico por imagen , Próstata/anatomía & histología , Próstata/diagnóstico por imagen , Antígeno Prostático Específico/sangre , Prostatectomía , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/cirugía , Hueso Púbico/diagnóstico por imagen , Reproducibilidad de los Resultados , Terapia Recuperativa , Vesículas Seminales/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Uretra/anatomía & histología , Uretra/diagnóstico por imagen
14.
J Clin Med ; 10(12)2021 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-34208267

RESUMEN

Endoscopic procedures such as ureteroscopy (URS) have seen a recent increase in single-use devices. Despite all the advantages provided by disposable ureteroscopes (sURSs), their cost effectiveness remains questionable, leading most teams to use a hybrid strategy combining reusable (rURS) and disposable devices. Our study aimed to create an economic model that estimated the cut-off value of rURS procedures needed to support the profitability of a hybrid strategy (HS) for ureteroscopy. We used a budget impact analysis (BIA) model that estimated the financial impact of an HS compared to 100% sURS use. The model included hospital volume, sterilization costs and the private or public status of the institution. Although the hybrid strategy generally remains the best economic and clinical option, a predictive BIA model is recommended for the decision-making. We found that the minimal optimal proportion of rURS procedures in an HS was mainly impacted by the activity volume and overall number of sterilization procedures. Private and public institutions must consider these variables and models in order to adapt their HS and remain profitable.

15.
J Cosmet Sci ; 61(4): 311-24, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20716439

RESUMEN

In previous studies, extract from Artocarpus incisus's heartwood (breadfruit tree) had antioxidant and antimelanogenic activities. Here, we investigated the extract's action on facial skin fibroblasts from wrinkled skin and nonwrinkled skin biopsies, particularly in the production of type I procollagen and metalloproteinase- 1 (MMP-1) and in the reorganization of collagen fibers. We found that the extract at a concentration of 50 microg/ml significantly enhanced percent viability and proliferation of wrinkled-skin fibroblasts. Flow cytometry showed that a 3.6-fold increased proportion of the wrinkled-skin fibroblasts were in their cell cycle S-phase, indicating increased proliferation. Type I procollagen synthesis by wrinkled-skin fibroblasts was augmented by the extract. Nonwrinkled-skin fibroblasts had higher synthesis and were unaffected by the extract. MMP-1 secretion was greater for wrinkled-skin fibroblasts, but the extract decreased its secretion for both fi broblasts samples. Fibroblasts were incorporated in collagen lattice disks. Lattices with nonwrinkled-skin fibroblasts contracted uniformly by 56% after a three-day culture and the extract had little effect. However, wrinkled-skin fi broblast lattices failed to show appreciable contractions (to 12% after three days). But remarkably, the extract conferred an ability of the wrinkled-skin fibroblast lattices to fully contract (to 53%). This shows that wrinkled-skin fi broblasts have the ability to reorganize collagen but that the extract can reactivate this latent potential. Our findings for the first time reveal that A. incisus's heartwood extract reversed the fibroblast deficiencies in the metabolism and reorganization of collagen and may underlie a wrinkle treatment.


Asunto(s)
Artocarpus/química , Extractos Vegetales/farmacología , Envejecimiento de la Piel/efectos de los fármacos , Piel/efectos de los fármacos , Recuento de Células , Proliferación Celular/efectos de los fármacos , Colágeno Tipo I/metabolismo , Femenino , Fibroblastos/efectos de los fármacos , Citometría de Flujo , Formazáns/química , Humanos , Metaloproteinasa 1 de la Matriz/metabolismo , Inhibidores de la Metaloproteinasa de la Matriz , Persona de Mediana Edad , Tallos de la Planta/química , Piel/citología , Piel/metabolismo , Piel/ultraestructura , Sales de Tetrazolio/química
16.
Geriatr Psychol Neuropsychiatr Vieil ; 18(2): 223-231, 2020 06 01.
Artículo en Francés | MEDLINE | ID: mdl-32554354

RESUMEN

BACKGROUND: Demographic changes require an adaptation of the geriatric care offer, which is readily oriented towards the community and including the development of out-of-hospital mobile geriatric team (MGT). Although psychiatric disorders of older persons require a comprehensive, integrative and multidisciplinary approach, geriatrics and old age psychiatry mobile units often work in parallel without concertation for the management of complex pathologies. The aim of this paper is to present the organisation and the results of a out-of-hospital MGT with a geriatrician and old age psychiatrists (OAP) in a same unit. METHOD: Data were collected during the first-year (2018) of the out-of-hospital MGT of Tours University hospital. After initial geriatric assessment and when old age psychiatry (OAP) intervention was needed, referral mode and justification, patient's characteristics and recommendations made by the team were collected. RESULTS: During the study period, 151 patients were assessed, 53% (n=80) had out-of-medical follow-up or difficulties to access to healthcare; 40% (n=60) had behavioural and psychological symptoms of dementia (BPSD), 30% (n=45) falls, 15% (n=23) social problems, 10% (n=15) alteration of overall health status and 5% (n=7) drug conciliation; 40% (n=60) benefited from an OAP evaluation; 100% (n=60) had out of medical follow-up, 83% (n=50) had severe BPSD, 17% (n=10) psychological symptom with psychiatric condition, 10% (n=6) misused psychotropic medications in charge of general comorbidities decompensation; 32% (n=19) had geriatric, OAP consultations and 33% (n=20) were in denial of care; 23% (n=14) with severe BPSD had a second OAP consultation. DISCUSSION: Relationship between geriatrician and OAP in the same MGT enables to deliver comprehensive care, including organic, psychiatric and cognitive comorbidities and collaborative assessment of iatrogenicity. A strengthened relationship with general practitioners is a possible option for these frail older patients, out-of-medical follow-up allowing their reintegration in the geriatric healthcare system.


Asunto(s)
Psiquiatría Geriátrica , Unidades Móviles de Salud , Grupo de Atención al Paciente , Rol del Médico , Servicios Urbanos de Salud , Anciano , Anciano de 80 o más Años , Femenino , Francia , Humanos , Masculino
17.
Urology ; 143: 68-74, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32540300

RESUMEN

OBJECTIVES: To assess the financial impact of switching to single-use ureteroscopes (sURS) in urolithiasis management for a hospital, over a 5-year period, and to identify possible solutions to contain or reduce it. METHODS: A Budget Impact (BI) model was designed for a public hospital performing around 200 ureteroscopies or extracorporeal shockwave lithotripsies per year. The BI was estimated as the difference between financial balances (between costs and revenues) of 2 environments (with and without sURS). The population was defined as adults treated for urolithiasis. The BI model was based on assumptions about the expected progression in the incidence of urolithiasis, and the expected change in clinical practices due to the availability of sURS. We considered the costs and revenues of hospital stays, the purchase price of sURS and the costs of digital or fiberoptic reusable ureteroscopes (rURS). Univariate and multivariate sensitivity analyses were performed. RESULTS: The cumulative 5-year financial impact of switching completely to sURS was €807,824 and €649,677 in comparison with fiberoptic and digital rURS respectively. This impact could be reduced by half or more if the health-care facility were to adopt different solutions, including negotiating the purchase price of sURS, developing outpatient activity and reducing production costs for ureteroscopy procedures. CONCLUSION: The BI model gives decision-makers a more accurate picture of the financial impact of switching to sURS and highlights ways to reduce the expected additional cost.


Asunto(s)
Ahorro de Costo , Equipos Desechables/economía , Ureteroscopios/economía , Urolitiasis/economía , Urolitiasis/cirugía , Diseño de Equipo , Francia , Humanos , Factores de Tiempo
18.
Cytotechnology ; 70(4): 1167-1176, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29564589

RESUMEN

Primary melanocytes in culture are useful models for studying epidermal pigmentation and efficacy of melanogenic compounds, or developing advanced therapy medicinal products. Cell extraction is an inevitable and critical step in the establishment of cell cultures. Many enzymatic methods for extracting and growing cells derived from human skin, such as melanocytes, are described in literature. They are usually based on two enzymatic steps, Trypsin in combination with Dispase, in order to separate dermis from epidermis and subsequently to provide a suspension of epidermal cells. The objective of this work was to develop and validate an extraction method of human skin melanocytes being simple, effective and applicable to smaller skin samples, and avoiding animal reagents. TrypLE™ product was tested on very limited size of human skin, equivalent of multiple 3-mm punch biopsies, and was compared to Trypsin/Dispase enzymes. Functionality of extracted cells was evaluated by analysis of viability, morphology and melanin production. In comparison with Trypsin/Dispase incubation method, the main advantages of TrypLE™ incubation method were the easier of separation between dermis and epidermis and the higher population of melanocytes after extraction. Both protocols preserved morphological and biological characteristics of melanocytes. The minimum size of skin sample that allowed the extraction of functional cells was 6 × 3-mm punch biopsies (e.g., 42 mm2) whatever the method used. In conclusion, this new procedure based on TrypLE™ incubation would be suitable for establishment of optimal primary melanocytes cultures for clinical applications and research.

19.
Photochem Photobiol ; 93(5): 1232-1239, 2017 10.
Artículo en Inglés | MEDLINE | ID: mdl-28477344

RESUMEN

This study aimed to evaluate the protective effect of artocarpin-enriched (Artocarpus altilis) heartwood extract on the mechanical properties of UVB-irradiated fibroblasts. Human skin fibroblasts were pretreated with 50 µg/mL-1 extract and later irradiated with UVB (200 mJ/cm-2 ). They were then cultured within three-dimensional of free-floating and tense collagen lattices. The pretreatment of fibroblasts with the extract prior to UVB radiation showed cells protection against UVB-induced suppression of α-SMA expression, fibroblast migration and contraction. These results reveal that the extract prevents mechanical damages induced by UVB irradiation in fibroblast-embedded collagen lattices, and therefore, has a potential as a natural photo-protectant.


Asunto(s)
Artocarpus/química , Lectinas de Unión a Manosa/farmacología , Extractos Vegetales/farmacología , Lectinas de Plantas/farmacología , Protectores contra Radiación/farmacología , Piel/efectos de la radiación , Rayos Ultravioleta , Actinas/metabolismo , Colágeno/metabolismo , Femenino , Fibroblastos/metabolismo , Fibroblastos/efectos de la radiación , Humanos , Integrina alfa2/metabolismo , Persona de Mediana Edad , Piel/citología , Piel/metabolismo , Envejecimiento de la Piel/efectos de los fármacos
20.
Int J Pharm ; 532(1): 623-634, 2017 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-28870768

RESUMEN

This unique work is targeted to achieve three main goals: i) to enhance the aqueous solubility of three specifically selected hydrophobic active agents, ii) to prepare such polymeric biodegradable microparticles which can encapsulate actives-cyclodextrin complexes and iii) to functionalize a polyamide base textile with active loaded microparticles and active-cyclodextrin loaded microparticles. To achieve this objective, biodegradable cationic microparticles were prepared via double emulsion solvent evaporation process and were loaded with hydroxypropyl-beta-cyclodextrin based complexes of Indomethacin, α-tocopheroland Lauryl Isoquinolinium Bromide during the formulation process. Inclusion complex based particles were evaluated for their morphology, size distribution, zeta potential, skin penetration aptitude and adsorption onto a selected textile. It was observed that active-cyclodextrin complex encapsulation do not affect the morphology, size and zeta potential of the microparticles as well as adsorption of the microparticles onto textile remains unaltered. However such active-cyclodextrin complex encapsulated particles provided the enhancement in the aqueous solubility of hydrophobic agents and also provided prolonged release formulations.


Asunto(s)
Sistemas de Liberación de Medicamentos , Absorción Cutánea , Textiles , 2-Hidroxipropil-beta-Ciclodextrina , Química Farmacéutica , Preparaciones de Acción Retardada , Humanos , Tamaño de la Partícula , Solubilidad , beta-Ciclodextrinas
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