Quelle strategie de depistage et de prise en charge des hepatites virales en entreprise ?

Introduction. Les hepatites virales posent un veritable probleme de sante publique en Cote d'ivoire. Le but de ce travail etait de rapporter la strategie de depistage et de prise en charge des hepatites virales au sein d'une entreprise financiere de la Cote d'Ivoire. Methodes. Il s'agissait d'une etude transversale qui s'est deroulee selon un chronogramme en trois phases du 18 aout 2014 au 12 septembre 2014 au sein des differentes agences de l'entreprise. La campagne de depistage avait ete precedee d'une conference de sensibilisation des agents de l'entreprise. Les marqueurs de depistage etaient l'Ag HBs et les AC anti HBc totaux pour l'hepatite B et l'Ac anti VHC pour l'hepatite C. Les patients dont les Ac anti VHC etaient positifs avaient eu un dosage de l'ARN viral C. Les travailleurs qui avaient deja ete vaccines; sans avoir ete depistes et qui apres depistage n'etaient pas porteurs les marqueurs de l'hepatite B positifs avaient eu un dosage quantitatif de l'Ac anti HBs. La serologie retrovirale; de meme que les anticorps anti VHD totaux avaient ete systematiquement recherches chez les travailleurs dont l'antigene HBs etaient positifs. De meme tous ceux qui etaient porteurs de l'ARN viral C ont ete systematiquement depistes pour le VIH. Les parametres d'etude etaient : le taux de participation; la prevalence de l'antigene HBs; la prevalence des Ac anti VHC; le nombre d'agents eligibles a la vaccination; le nombre de patients eligibles a un traitement anti viral; le nombre de patients non eligibles a un traitement mais sous surveillance. Resultats. 1025 agents sur un effectif de 1137 avaient participe a la campagne de depistage soit un taux de participation de 90;14%. La prevalence des marqueurs de l'hepatite B et C etaient respectivement de 6;34% et de 1;46%. Sur 80 personnes depistees positives a l'hepatite B et C; seules 67 ont ete prises en charge (83;75%) les 11 autres (16;25%) n'avaient pas repondu a la convocation du medecin. 224 agents avaient ete proposes pour la vaccination. La mise en route du traitement antiviral B avait concerne 07 patients soit 12;96% des patients porteurs de l'hepatite B et 01 seul patient pour l'hepatite C. Conclusion. La strategie de lutte contre les hepatites virales au sein de cette entreprise a ete favorablement accueillie par les travailleurs de celle -ci; avec un taux de participation de 90;14% pour le depistage. La prevalence de l'hepatite B reste elevee (6;34%). Un plaidoyer pour une meilleure accessibilite au Tenofovir et aux DASS merite d'etre fait

Determination of the bioavailability of gentamicin to the lungs following inhalation from two jet nebulizers.

AIMS: To determine the bioavailability of gentamicin to the lung following inhalation from two jet nebulizers. METHODS: Serial urine samples were obtained from 10 volunteers after a 80 mg dose given orally, nebulized from a Pari LC + (PARI) and MicroNeb III (MN) devices, or after a 40 mg intravenous dose. In vitro aerodynamic characteristics of the nebulized doses were also determined. RESULTS: The mean (SD) absolute gentamicin lung bioavailalibility following delivery by PARI and MN devices was 1.4 (0.4) and 1.7 (0.5) %. The mass median aerodynamic diameter (MMAD) of the drug particles from the PARI and MN systems was 8.6 (0.6) and 6.7 (0.5) microm and the corresponding fine particle doses (FPD) were 10.2 (2.8) and 11.7 (1.5) mg. CONCLUSIONS: The MMAD and FPD data reflect the poor lung deposition of gentamicin identified by urinary excretion.

Enantiomeric purity determination of propranolol by capillary electrophoresis using dual cyclodextrins and a polyacrylamide-coated capillary.

The use of a chirally selective capillary electrophoresis method is reported for the enantioselective purity determination of propranolol drug substance. The method employed a combination of both charged and neutral cyclodextrin. An internally coated capillary was used to suppress electroosmotic flow and potential peak tailing. The method was capable of monitoring below 0.1% m/m of the undesired impurity. Acceptable validation data was also obtained for recovery, linearity, and for both short and long-term injection precision.

Rapid resolution of drugs and related substances with an eCAP polyamine coated capillary.

The long term stability of a commercial polyamine coated capillary (eCAP) is described. The capillary, which can be used in the CZE and MEKC mode, is based on coating with a polyamine after conditioning with 1 M NaOH and regeneration of this coating after each run. The stability was tested over 6 months on the drug trimethoprim and the R.S.D. values for migration time and peak area were 2.86 and 3.62% respectively (n = 8, each time of determination) (> 600 sample injections over the period). This stability was utilised in the validated method developed for trimethoprim and four of its related impurities. The repeatability of peak area for trimethoprim (without normalisation or external standard) was, within-day R.S.D. = 1.02% (n = 8) and between-days R.S.D. = 2.02% (n = 8 each day). Linearity was good (for 50 micrograms ml-1 target) (y = 249.6x + 17.3 (r = 0.992, n = 6). These results for trimethoprim and for other drug mixtures were comparison with conventional capillaries and the advantage of reducing the polyamine treated eCAP capillary to a minimum length is described, to achieve rapid assay of the 5 component timethoprim mixture in < 2 min.