Study of the influence of alcohol on the photostability of four UV filters.

OBJECTIVE: Spray formulations are currently under development in the field of topical photoprotection. Such forms are characterized by their high fluidity, a property that is obtained by the presence of alcohol in the formula. The purpose of this work was to study the influence of ethanol in sunscreens on the photoprotective efficacy as well as the photostability of UV filters. MATERIALS AND METHODS: The filters tested were octyl methoxycinnamate (OMC), PEG-25 PABA, octyl salicylate and butyl methoxydibenzoylmethane (BMDBM) at their maximum concentration authorized by European regulations and in the presence of increasing amounts of alcohol, up to 15% (w/w). RESULTS: The effect of the presence of alcohol on the efficacy of the filters and their photostability varies depending on the molecule considered. Alcohol has no effect on octyl salicylate, either on its efficacy or its photostability. However, filter stabilization is seen for BMDBM and PEG-25 PABA. CONCLUSIONS: Although these differences are significant, they are not great enough to justify large-scale use of ethanol in sunscreen products due to some of its properties, such as flammability.

Soap and syndets: differences and analogies, sources of great confusion.

OBJECTIVE: Soap has been used by humankind since ancient times and was probably already known to the Sumerians. It is a fatty acid salt obtained from the reaction of a strong base with a fatty substance of animal (tallow) or plant origin (oil). This reaction is called saponification. Syndets, on the other hand, are much more recent and have been in use for about a century. In the case of liquid syndets, they are mainly alkyl sulphates and their derivatives alkyl ether sulphates while isethionates and sarcosinates are more commonly found in solid syndets. Synthetic soaps and detergents are surfactants and, as such, they have detergent properties. The way soap works accounts for its antimicrobial properties. Thanks to its amphiphilic structure, it is able to interact with the lipid membranes of microorganisms (viruses, bacteria, etc.) and inactivate them. In this coronavirus pandemic period, health authorities worldwide recommend hand washing with soap and water. We therefore wanted to provide a summary of the chemical characteristics and applications of soaps, on the one hand, and synthetic detergents, on the other. Soap is not the only product used for hand hygiene and, given the current situation, alternatives are complex and varied.

Influence of Cosmetic Type and Distribution Channel on the Presence of Regulated Fragrance Allergens: Study of 2044 Commercial Products.

Contact dermatitis linked to cosmetic products is a very common reason for visits to the dermatologist, and in more than half the cases, it is due to an allergic reaction. Fragrances are most often the culprit. The aim of the study was to describe the common fragrance allergens in different categories of cosmetic products available on the European market. We wanted to assess the influence of cosmetic type and distribution channel on the presence of fragrance allergens. There are the allergens whose concentration exceeds 0.001% in leave-on products and 0.01% in rinse-off products. A total of 2044 commercial hygiene, care, and makeup cosmetic products were analyzed to specifically study regulated fragrance allergens. The influence that the product category and its distribution channel (retail stores and specialized stores such as beauty institutes or hairdressers and pharmacy) have on the prevalence of these allergens was evaluated. The Kruskal-Wallis test has been used for statistical data analysis. There is a wide range of fragrance allergens, the most common being limonene (found in about 30% of products tested), linalool (just over a quarter of the products tested), and benzyl alcohol (approximately 16% of the products tested). The average number of allergens found and their nature varies depending on the type of product in question (maximum number for shampoos and oral care with about 70 allergens and minimum number for nail polish and makeup for eyes with fewer than 10 allergens). In the area of hygiene, deodorants and oral hygiene products are particularly noteworthy, the former for their significantly high number of allergens and the latter for their low number. There is also a significant difference between the number of allergens found in eye makeup and foundations. Our results indicate that the number of regulated fragrance allergens is particularly influenced by the type of products.

Mitigating the photocurrent persistence of single ZnO nanowires for low noise photodetection applications.

In this work, we investigate the optoelectronic properties of zinc oxide (ZnO) nanowires, which are good candidates for applications based on integrated optics. Single ZnO nanowire photodetectors were fabricated with ohmic contacts. By taking current transient measurements in different atmospheres (oxygen, air, vacuum and argon), and at various temperatures, we point out the importance of surface effects on the electrical behaviour. Results confirm that oxygen chemisorption is responsible for the existence of a high photoconductive gain in these devices, and for the first time a two step process in the photocurrent rise transient is reported. A maximum gain of G = 7.8 × 107 is achieved. However, under certain conditions, the persistence of the photocurrent can last up to several hours and as such may prevent the device from operating at useful rates. From a knowledge of the photocurrent response mechanisms, we establish a method to restore the photodetector to its initial state, with very low dark current, by applying an appropriate gate voltage sequence. This advances the state of the art for these detectors towards commercial applications.

Study of the influence of substrate and spectrophotometer characteristics on the in vitro measurement of sunscreens efficiency.

All the methods used for the in vitro measurement of the SPF, the universal indicator of sunscreens efficiency, rely on a spectrophotometric analysis. What can vary about the experimental protocol used is mainly the substrate and the type of spectrophotometer chosen. We decided to work with polymethylmetacrylate plates that we analyzed using two spectrophotometers equipped with integrating spheres, the UV1000S and the UV2000 apparatus. Two marketed products were such tested, after spreading 2 mg/cm2 on the plates, using one apparatus after another. We applied a non-parametric Wilcoxon test for paired data to the measures realized on 10 plates (as we systematically used the 2 apparatus), in order to compare the series of measures obtained with the two machines. This way, we were able to show a significant difference between the SPF values respectively obtained with the UV1000S and the UV2000 spectrophotometers. This difference could be explained by the decrease of the stray light in the case of the UV2000 apparatus.

Improving free-flap survival using intra-operative heparin: Ritualistic practice or evidence-base medicine? A systematic review.

INTRODUCTION: The failure rate of free flaps is approximately 5%, mostly due to thrombosis of microvascular anastomosis. A number of pharmacological agents have been tested in order to enhance the patency of microvascular anastomosis and so to as extend the survival of free flaps. One of them is heparin, a very commonly used anticoagulant. However, there exists no consensus on its use in microsurgery as concerns time of introduction (pre-, intra- or post-operative), recommended dosage, or duration of utilization. The aim of this study was to determine whether or not the use of intra-operative heparin, in its systemic or topical forms, can bring about improved survival of free flaps, and if and when it should be recommended in microsurgery. MATERIAL AND METHODS: A systematic review on the PUBMED database enabled us to identify articles evaluating the benefits of intra-operative heparin with regard to free-flap survival. All in all, fifteen articles in animal and human research were selected. RESULTS: As far as animal research is concerned, 9 studies out of 11 showed the superiority of topical intra-operative heparin compared to saline in improving free-flap survival rates through improved patency of the anastomosis. As regards systemic intra-operative heparin, on the other hand, only two trials out of four yielded favorable results. In clinical research in humans, there has been no prospective randomized trial studying the action of topical intra-operative heparin in vessel irrigation of ex-vivo free flaps before vascular repermeabilisation. However, the preliminary results of four trials seem to provide positive arguments for this practice. CONCLUSION: The use of systemic per-operative heparin (intravenous injection) does not improve the survival of free flaps in either animal models or humans. In animal models, however, the use of topical intra-operative heparin (vessel irrigation) has been shown to improve the free-flap survival rate by avoiding thrombosis of microvascular anastomosis. Finally, in clinical studies concerning humans, as of now no prospective randomized trial has proven that use of topical intra-operative heparin to ensure vessel irrigation in ex-vivo flaps is likely to increase free-flap survival. Studies should be conducted to decide whether or not to validate a rather ritualistic practice that consists in irrigating the relevant vessels before anastomosis; does it or does it not improve the patency rate?

[Comparison of various topical sun protection formulations, based on cosmetic vs medical device status, using in vitro methods to assess their efficacy, photo-stability and water resistance]. / Comparaison de produits de protection solaire ayant un statut de cosmétique ou de dispositif médical par détermination de leur efficacité, de leur photo-stabilité et de leur résistance à l'eau grâce à une méthode in vitro.

BACKGROUND: Within the European Union, sun protection products have long been considered cosmetics whereas in other parts of the world, such as the United States, they are considered as medicinal products. In France, sun protection products with medical device status have recently appeared. Our aim was to compare medical and cosmetic sun protection products. MATERIALS AND METHODS: We subjected 4 sun protection products to in vitro testing in order to determine their efficacy in the UVB and UVA ranges, as well as their photo-stability and water resistance. We tested two cosmetic products (Dépiwhite S Soin photoprotecteur(®) SPF 50+ and Urgo cicatrices(®) SPF 30) and two class I medical devices (MD) (Actinica lotion(®) and Kelocote UV(®) Gel for scars). The main in vitro method used involved measuring the transmittance of a sample of each product applied to a dish containing poly(methyl methacrylate) using a spectrophotometer with integrating spheres. This method enabled us to determine the SPF of the various products as well as their photo-stability and degree of water resistance. RESULTS: Regarding efficacy, three of the four test products met the European recommendations governing sun protection products, i.e. a ratio between UVB and UVA protection of 3 or less, and a critical wavelength (λc) of 370 nm or higher. Actinica lotion(®) was the more effective of the two medical devices tested, and was also the most photo-stable, at least within the UVB range. All four products tested were water-resistant. DISCUSSION: The products tested, while having different status and different claims, exhibited equivalent filtration properties under the study conditions.

Effect of the product type, of the amount of applied sunscreen product and the level of protection in the UVB range on the level of protection achieved in the UVA range.

Using a topical product is part of the overall strategy for skin cancer prevention. The level of protection attainable when using commercial products is indicated by the Sun Protection Factor (SPF) value, in use everywhere. This value reflects the level of protection primarily in the UVB range. However, UVA radiation also has deleterious effects on the skin, and it is essential to prevent it, which is why products must offer a wide spectrum of protection. Tests conducted in vivo, before any marketing, are done by applying the studied product at a rate of 2.0 mg cm(-2), while users, in practice, only use 1.0-1.5 mg cm(-2). We now know that this reduction in the amount of applied product greatly affects the SPF. To complete the state of knowledge in this area, we sought to evaluate the effect of a decrease in the amount of applied sunscreen product by studying sunscreen creams and oils on the level of protection attainable in the UVA range. We have shown that the PF-UVA is divided by a factor of 2.2, on average, when the amount of applied product is reduced by half, with differences depending on the product type under consideration (cream or oil) and depending on the SPF of the preparation.

[Methods of induction of labor in termination of pregnancy after 22weeks: About 3procedures]. / Modalités d'induction du travail des interruptions médicales de grossesse après 22SA : à propos de 3protocoles.

OBJECTIVES: To propose a protocol for induction of labor to terminate pregnancy after 22weeks of amenorrhea allowing to decrease the duration of labor and of hospitalization but also, allowing to reduce the number of emergency pretreatment-induced fetal death, to improve the experience of the patients and to limit the cost. METHODS: We realized a retrospective single-center study including 269patients and comparing three protocols, with and without laminaria and with various intervals mifepristone-misoprostol (14 and 38hours). The outcome measures were the misoprostol-delivery interval, the delivery time and the number of emergency pretreatment-induced fetal death. RESULTS: We showed that the misoprostol-delivery interval and the delivery time were comparable for the three periods of our study, even after decrease of 24hours of the mifepristone-misoprostol interval and in the absence of laminaria. The misoprostol-delivery interval was between 7h30 and 8h35 between protocols (P=0.055). The delivery time was between 5:18pm and 6:48pm between protocols (P=0.252). The early administration of misoprostol allowed the patients to give birth earlier (P=0.001). Finally, we showed that the increase of the size and the number of laminarias were risk factors of emergency pretreatment-induced fetal death (respectively P=0.013 and P=0.002). CONCLUSION: The absence of laminaria and the reduction of the interval mifepristone-misoprostol of 24hours do not change the time to delivery and allow to reduce the duration of hospitalization, the number of emergency pretreatment-induced fetal death and the cost of the TOP.

Tris-biphenyl triazine, a new ultraviolet filter studied in terms of photoprotective efficacy.

There are relatively few authorized ultraviolet filters in Europe and this presents a certain number of problems when we want to formulate a sun protection product which both ensures a high level of protection and respects the recommendations in force in terms of broad-spectrum efficacy, with, in particular, a critical wavelength (λc) greater than or equal to 370 nm. A new ultraviolet filter has just been launched on the market. Known as tris-biphenyl triazine, it is the first filter to be registered on Annexe VI of "Cosmetics Regulation" (EC) No. 1223/2009 of the European Parliament and of the Council, which gives a list of the ultraviolet filters allowed in cosmetic products, since the regulation came into force in July 2013. This filter is both very effective (as it enables 2 SPF units and 1 UVA-PF units to be obtained respectively, by percentage of use) and very photostable (since the SPF and UVA-PF do not vary after 2h of irradiation in a solar simulator). Its broad spectrum associated with its qualities in terms of efficacy and photostability make it a choice ingredient for the formulation of sun protection products.

Study of the persistence of the anti-inflammatory effect observed after application of preparations containing organic ultraviolet filters.

Given that previous studies have highlighted the anti-inflammatory nature, which is influenced by UV radiation, of a certain number of ultraviolet filters currently used in Europe, it seemed interesting to evaluate the persistence of this type of effect. The persistence of the anti-inflammatory effect of fourteen preparations, each containing one of the ultraviolet filters authorized by Regulation (CE) No. 1223/2009, and of 10 commercially-available sun products was studied using the phorbol-myristate-acetate test on mice, up to 6 and a half hours after application. We can observe that a benzophenone, oxybenzone, a PABA derivative, octyldimethylPABA and a derivative of cinnamic acid, OMC as well as 3 commercially-available products, display a very marked anti-inflammatory effect at the end of our experimentation phase. The type of effect observed could encourage users to prolong the time that they are exposed to the sun, due to there being no warning signs, namely sunburn.

Sun oils: effect of the applied dose on SPF determined by using in vitro method.

The relationship between skin cancer and exposure to the sun is now clearly established. It is therefore necessary to ensure that consumers have effective sun protection. The effectiveness of the anti-solar products is quantified using a universal indicator, the SPF (sun protection factor). This value can be given in two different ways: by in vivo (standard ISO 24444:2010) and in vitro methods. The in vitro method was adopted for this study, for ethical reasons. The protective effect regarding non-melanoma cancers given by sun products has been proven. It is nevertheless a fact that consumers need to be made aware. Indeed, the quantity of sun protection product applied in reality by the consumer is clearly lower than the recommended amount. Under these conditions, the following question can be asked: What is the level of protection attained if half or even a quarter of the recommended dose of product is applied? In order to answer this question, 20 oils available on the market were tested in vitro at five different doses (5, 7.5, 10, 12.5, 15.0 mg over a surface of 25 cm(2)). We showed that a ratio of two polynomial functions exists between the SPF and the final mass of the product. The factors reducing the efficacy when the dose is divided by 2 are very variable, ranging from 2 to 4 according to which product is studied.

[Port-site metastasis after retroperitoneal lymphadenectomy for endometrial adenocarcinoma]. / Métastase orificielle sur site de trocart après lymphadénectomie rétropéritonéale pour un adénocarcinome endométrial.

Port-site metastasis is a rare but serious complication of laparoscopic surgery. The etiologies are poorly identified and multiple. We report the case of port-site metastasis after laparoscopic retroperitoneal lymphadenectomy for endometrial adenocarcinoma. In the literature, three cases of port-site metastasis after laparoscopic retroperitoneal lymphadenectomy are reported: two cases concerning cervical cancer and one case concerning a kidney cancer. To our knowledge, this is the only case about port site metastasis after laparoscopic retroperitoneal lymphadenectomy for endometrial adenocarcinoma.

The effect of ultraviolet radiation on the anti-inflammatory effect of filters.

A certain number of filters have notable anti-inflammatory properties with percentage inhibition of PMA-induced edema in mice at over 70%. The question arose as to whether this effect was likely to continue after UV irradiation. It can be noted that 7 filters retain an equivalent anti-inflammatory effect before and after 2h of irradiation in a Suntest device (650 W/m(2)). For 9 filters, the anti-inflammatory effect decreases and for 5 filters, the anti-inflammatory effect increases. Various behaviors should be noted. 3 groups of substances can be distinguished: such as phenylbenzimidazole sulfonic acid which loses its anti-inflammatory character after irradiation (the percentage inhibition falls from 80 to 44%), oxybenzone which retains a constant anti-inflammatory character (89% inhibition before and after irradiation and also octyl methoxycinnamate which becomes very anti-inflammatory (with a percentage inhibition of 93%). The same phenomenon is observed in the case of commercial products. This should be made known as it can have a considerable impact on the results which are displayed on the packaging of sun products.

[Management of preterm and prelabour rupture of membranes in France]. / Pratiques en France de prise en charge des ruptures prématurées des membranes.

INTRODUCTION: Preterm premature rupture of the membranes (PPROM) is a frequent complication of pregnancy leading to prematurity and neonatal infection. The management of PPROM is not consensual in France and practices between maternities are variable. We subjected type 2B and 3 maternity units to a questionnaire regarding their practices concerning the PPROM. RESULTS: Our study includes 59 type 2B maternity units and 59 type 3 maternity units. Corticotherapy is proposed in all of type 3 maternity units and in 96.5% of type 2B maternity units. Antibiotics are administered at the patient admission in 96.6% of type 3 maternity units and 86% of type 2B maternity units. Tocolytics are used systematically in 31% of maternity units and only in case of contractions in 62% of maternity units. No maternity unit indicates birth systematically after corticotherapy before 32 weeks of gestation (WG). An early delivery is proposed in 9.5% of maternity units between 32 and 34 WG and in 58% of maternity units between 34 and 37 WG. CONCLUSION: Corticotherapy and antibiotics are predominantly administered at the time of the diagnosis, as recommended by the HAS and CNGOF. Despite the lack of recommendation, an expectative management until 34 WG, in absence of any sign of chorioamnionitis, seems to be the choice of most maternity units.

Influence on SPF of the quantity of sunscreen product applied.

It is now a clearly established fact that ultraviolet radiation is involved in the induction of skin cancer such as carcinoma and melanoma. The most efficient means of protection is by using clothes. For uncovered areas, it is essential to apply a sun product. For some time, various authors have been wondering about the inefficiency or indeed the dangerousness of sun products. Cases of sunburn are still just as frequent in children. We have chosen to study the influence of the quantity of sun product applied on the skin on the level of efficiency obtained. Twenty commercially-available products with SPFs varying between 10 and 50+ and belonging to all levels of protection, that is to say "low", "medium" and "high", were tested in vitro at 5 different doses (5.0, 7.5, 10.0, 12.5 and 15.0 mg for a surface area of 25 cm(2)). We were able to demonstrate that there was a polynomial relationship between the SPF and the quantity of product on the skin's surface. It can be seen that when the dose is halved, the SPF is divided by a variable factor according to the product, from 1.5 to 3.8.

Comparison of two in vitro methods to evaluate the water resistance of sunscreens.

For a long time, the water resistance of sunscreens has been determined in vivo, according to Colipa's (Comité de Liaison des Industries de la Parfumerie) procedure. This method is not so ethical as healthy volunteers are irradiated, and can be replaced by an in vitro method which is easy and quick to perform. The objective of this work was to correlate the experimental device proposed by Choquenet et al. and the dissolutest (Sotax AT6). This equipment is used in the pharmaceutical industry to control the tablets. The experimental conditions have been fixed to correlate the results obtained with both methods. The stirring speed for the dissolutest was fixed at 75 rpm, which is the speed value recommended by the European Pharmacopeia to study the dissolution over time of tablets.

Interest of external photoprotection by means of clothing and sunscreen products in young children.

BACKGROUND: Protecting young children is a major public health issue. OBJECTIVE: We tested children's clothing and sunscreen products that are specially designed for children. METHODS: The effectiveness of the different types of clothing and sunscreen products was determined using spectrophotometer equipped with an integrating sphere A measure of transmittance carried out, respectively, between 290 and 400 nm and between 320 and 400 nm, allowed us to assess the photoprotective properties in the UVB and UVA range respectively. RESULTS: Although the photoprotective effect varies according to the type of clothing (UV-protection factor [UPF] of approximately 10 for a cotton T-shirt and 500 for a pair of jeans), the effect is constant for any one type of clothing. Placing fabrics in layers is essential and this enables the protective effect to be greatly increased. Moreover, the authors wished to answer the question, 'what makes a good sun cream?' by analysing the formula of each product tested. It turns out that only creams containing both organic filters and inorganic filters have an sun protection factor (SPF) that is the same as the one stated on the product. CONCLUSION: Concerning townwear, the jeans, tracksuits, sweatshirts, pullovers and tights turned out to be very photoprotective. They enable, in effect, to reach a UPF higher than 500. The mere presence of titanium dioxide and/or zinc dioxide does not mean that the product will have a high SPF. Products containing alcohol can be eliminated from the possible choices by carefully reading the label.

Sunscreen products: what do they protect us from?

Whereas for fifty or so years acquiring a tan has been the trend for aesthetic reasons relating to current beauty criteria, the health authorities are now advocating vigilance in this area, prompted by the knowledge of the harmful effects of the sun, especially from its ultra-violet rays. In the European Union, sunscreen products are considered cosmetics and tests on their effectiveness can be performed in vivo or in vitro to determine four effectiveness indicators: the SPF (Sun Protection Factor), the PF-UVA (UVA Protection Factor), the SPF/PF-UVA ratio and the critical wave length. It is the erythemal SPF which is measured in the vast majority of cases: it can therefore be confirmed that sunscreen products protect us from sunburn under good conditions of use. We thought it would be interesting to calculate other indicators to assess protection against non-melanoma skin cancers (NMSC) and to quantify the effectiveness of the product against UVA1 or UVA2. To characterize the products tested, we have determined in vitro different SPF and PF-UVA values, by using not just the erythemal weighting factor but also the weighting factor relating to the non-melanocytic skin cancer (SPF(cnm) and PF-UVA(cnm)), by getting away from any weighting factor (SPF(m) and PF-UVA(m)) and lastly, by varying the integration limits to quantify the effectiveness of the tested product in the UVB (290-320 nm), UVA1 (340-400 nm) and UVA2 320-340 nm) fields. In this way, and using these new indicators, we have been able to qualify eleven commercial products-ten cosmetic products and one medical device. It can be interesting to take into account the non-melanocytic skin cancer protection in order to qualify the sunscreen products.

What level of protection can be obtained using sun protective clothing? Determining effectiveness using an in vitro method.

It has been clearly demonstrated that ultraviolet radiation is harmful to the skin and can cause helioderma and cancers. There are different methods of combating ultraviolet radiation: sunscreens formulated with filters and/or screens as well as clothing. For this work, the authors studied different fabrics to evaluate what effect the type, color and thickness of an article of clothing might have in terms of providing UVB (UPF) and UVA (UPF-UVA) protection. This study was conducted using a spectrophotometer equipped with an integrating sphere and allowed the authors to discover that certain fabrics have UPF values which exceed 500, making them vastly superior to sunscreen creams. Synthetic fabrics appear to provide the highest level of sun protection.