Image analysis quantification of sticking and picking events of pharmaceutical powders compressed on a rotary tablet press simulator.

PURPOSE: The aim of this work was to develop a quantification method based on image analysis, able to characterize sticking during pharmaceutical tableting. Relationship between image analysis features and relevant mechanical parameters recorded on an instrumented tablet press simulator were investigated. METHODS: Image analysis, based on gray levels co-occurrence matrices (GLCM), generated textural features of the tablet surface. The tableting simulator (Stylcam® 200R, Medelpharm), instrumented with force and displacement transducers, provided accurate records. The tablet defects and compaction process parameters were studied using three pharmaceutical powders (Fast-Flo® lactose, anhydrous Emcompress® and Avicel® PH200 microcrystalline cellulose), five compression pressures (60 to 250 MPa), five lubricating levels, and three types of punches (standard steel, amorphous hard carbon and anti-sticking punches). RESULTS: Texture parameters made it possible to quantify with precision tablets' aspect. The selected parameter IC2 (Information on Correlation 2) plotted versus the ratio between the ejection shear stress (Esh) and the compression pressure (Cp) let appear a relevant knowledge space where it was possible to identify a normal and a degraded tableting mode. A positive link between those two parameters was shown. CONCLUSION: Since the Esh/Cp ratio was related to image analysis results, it proved to be an interesting defect tag.

Research response to coronavirus disease 2019 needed better coordination and collaboration: a living mapping of registered trials.

OBJECTIVES: Researchers worldwide are actively engaging in research activities to search for preventive and therapeutic interventions against coronavirus disease 2019 (COVID-19). Our aim was to describe the planning of randomized controlled trials (RCTs) in terms of timing related to the course of the COVID-19 epidemic and research question evaluated. STUDY DESIGN AND SETTING: We performed a living mapping of RCTs registered in the WHO International Clinical Trials Registry Platform. We systematically search the platform every week for all RCTs evaluating preventive interventions and treatments for COVID-19 and created a publicly available interactive mapping tool at https://covid-nma.com to visualize all trials registered. RESULTS: By August 12, 2020, 1,568 trials for COVID-19 were registered worldwide. Overall, the median ([Q1-Q3]; range) delay between the first case recorded in each country and the first RCT registered was 47 days ([33-67]; 15-163). For the 9 countries with the highest number of trials registered, most trials were registered after the peak of the epidemic (from 100% trials in Italy to 38% in the United States). Most trials evaluated treatments (1,333 trials; 85%); only 223 (14%) evaluated preventive strategies and 12 postacute period intervention. A total of 254 trials were planned to assess different regimens of hydroxychloroquine with an expected sample size of 110,883 patients. CONCLUSION: This living mapping analysis showed that COVID-19 trials have relatively small sample size with certain redundancy in research questions. Most trials were registered when the first peak of the pandemic has passed.

The use of a GripForce system to map force distribution patterns of laparoscopic instruments.

While it is acknowledged that the forces required to manipulate laparoscopic instruments can be significant and are important in terms of potential discomfort after prolonged use, no systematic study has been conducted. In this paper we present a GripForce system that allows for the mapping of force distribution patterns of laparoscopic instruments. Initial results showed significant differences in force distribution between various instrument handles, thus demonstrating the viability of the system and proposed methodology. Analysis of force distribution patterns of laparoscopic instruments can help towards improving instrument design, better understanding the relationship between force applied and performance, as well as provide useful feedback to trainees and surgeons.

[Embolization of an intraparenchymal aneurysm of the left kidney responsible for recurrent haematuria]. / Embolisation d'un anévrisme intra-parenchymateux du rein gauche responsable d'une hématurie a répétition.

The authors report the case of a patient hospitalised for an episode of massive haematuria with clots requiring drainage by urethral stent. After an initial work-up comprising CT urography, considered to be normal, and a non-contributive ureteroscopy, renal CT angiography was performed, revealing an intraparenchymal aneurysm of the right kidney, about 15 mm in diameter. Two embolizations of this vascular malformation avoided the need for haemostasis surgery.

[Leiomyoma of the female urethra]. / Léïomyome de l'urètre féminin.

The authors report a case of leiomyoma of the female urethra and review the literature concerning this disease. This is a rare tumour that only exceptionally involves the urethra and is therefore difficult to diagnose. Urethral leiomyoma can present in the form of urinary tract infections, detrusor instability, haematuria, dyspareunia, and, more rarely, dilatation of the proximal urinary tract. Treatment is surgical. There is no risk of metastases, but local recurrence can occur in the case of incomplete resection.

[Solitary fibrous tumor of the kidney]. / Tumeur fibreuse solitaire de la loge rénale.

The diagnosis of solitary fibrous tumour, usually a benign lesion, is rarely suggested in a case of renal mass due to the rarity of these lesions. The authors report a case of a very large hilar mass in a 35-year-old man. Histological examination was performed on the operative specimen, as preliminary CT-guided needle biopsy was non-diagnostic. The diagnosis of primary spindle cell tumour was confirmed by immunohistochemical analysis. Independently of the size of this tumour and its intimate relations with the hilar region, large surgical resection should be performed due to the possible presence of malignant contingents and the risk of local recurrence or metastatic spread.