Marc Montana

Organic Glues or Fibrin Glues from Pooled Plasma: Efficacy, Safety and Potential as Scaffold Delivery Systems

Since 1976, fibrin glues have been attracting medical interest, spreading from their initial use as a hemostatic agent in cardiovascular surgery to other fields of surgery. Studies have compared the efficacy of fibrin glues vs sutures in surgery. However, few comparisons have been made of the efficacy and safety of the different fibrin glues commercially available. Recently, fibrin glues have been tested as a scaffold delivery system for various substances inside the body (drugs, growth factors, stem cells). The infectious risk (viruses, new germs) of this blood-derived product was also studied in assays on viral inactivation methods. The development of autologous fibrin glues offers a solution to the problem of infectious risk. This review examines the current state of knowledge on the efficacy, safety and future potential of fibrin glues.

RAPID SYNTHESIS OF NEW AZAHETEROCYCLIC HYDROXYMALONATE DERIVATIVES USING TDAE APPROACH

- A new series of azaheterocyclic hydroxymalonate derivatives was synthesized from reaction between chloromethyl azaheterocycles and diethyl oxomalonate using tetrakis(dimethylamino)ethylene (TDAE).

Synthesis of New Quinoxalines Containing an Oxirane Ring by the TDAE Strategy and in Vitro Evaluation in Neuroblastoma Cell Lines

Neuroblastoma is an aggressive pediatric malignancy with significant chemotherapeutic resistance. In order to obtain new compounds active on neuroblastoma cell lines, we investigated the reactivity of carbanion formed via TDAE in quinoxaline series. The new synthesized compounds were tested for their anti-proliferative activity on two neuroblastoma cell lines, and seven oxirane derivatives obtained interesting activities.

TDAE-Initiated Synthesis of Oxiranes in Heterocyclic Series: Reaction of 2-(Dibromomethyl)quinoxaline with α-Dicarbonyl Derivatives

A new series of quinoxalinic oxirane derivatives was synthesized from reaction between 2-(dibromomethyl) quinoxaline and alpha-dicarbonyl compounds using tetrakis(dimethylamino) ethylene (TDAE).

Anaphylactic Reaction to Pemetrexed: A Case Report

Pemetrexed is approved to treat non-small cell lung cancer and has an overall favorable toxicity profile. We describe a 58-year-old man who developped an anaphylactic shock within few minutes from the beginning of pemetrexed perfusion. Pemetrexed was discontinued and the patients symptoms gradually resolved with administration of symptomatic treatment. Serum tryptase level remained normal and intra dermal skin tests were negative eventhough a nonspecific papule was noted. This case suggests that caution should be exercised when prescribing pemetrexed and clinicians must be warranted for the possibility of serious adverse events associated with pemetrexed use.

Body image and psychological distress in women with breast cancer: a French online survey on patients’ perceptions and expectations

BackgroundAltered body image caused by alopecia, loss of eyebrows or eyelashes, or mastectomy is a major source of psychological distress in women with breast cancer.ObjectiveTo identify and to assess patients’ perceptions and expectations regarding altered body image.MethodOpinion survey conducted among patients treated for breast cancer and member of French online support groups. Anonymous online self-administered survey sent to women with breast cancer.Results85% of the women interviewed experienced alopecia during treatment and 67% of them loss of eyebrows or eyelashes. About half of patients suffering alopecia and loss of eyebrows or eyelashes reported fearing what others think. Mastectomy was experienced by 84% of the women in our study, but only 32% of them reported fearing what others think. 87% of our study cohort received information about the possibility of adverse events. 70, 56, and 60% of women felt helped by information they received for the management of alopecia, loss of eyebrows or eyelashes, or mastectomy, respectively.ConclusionThis study confirms that altered body image is a critical psychosocial issue for women with breast cancer. Effective information can be a source of reassurance and may constitute one of the most important sources of emotional support.

Mise au point sur le traitement de l’hémangiome du nourrisson par bêta-bloquant

Hemangiomas are benign tumors most commonly encountered in infancy and early childhood. While most of them regress spontaneously, some require treatment due to a significant proliferation, which may be complicated by ulceration, deformation aesthetic deformation or worse impairment vital. Among the treatments used corticosteroids is the standard treatment but its use in high doses expose to potential risks. In 2008, the discovery by chance of the effectiveness of propranolol in the management of hemangioma revolutionizes the first line treatment. Its mechanism of action is not yet well understood and establishment of such treatment should be done by a hospital paediatrician in the absence of any contraindications. This article proposes focus on effectiveness and tolerance of β-blockers used as treatment of infantile hemangiomas.

Stability of a highly concentrated solution of epirubicin for conventional transcatheter arterial chemoembolization

INTRODUCTIONnEpirubicin is widely used for conventional transcatheter arterial chemoembolization (cTACE) in patients with hepatocellular-carcinoma. However, there is no data about its stability in solution at concentration higher than 2 mg/L, yet needed when mixing it with a standard volume of Lipiodol(®) to produce an efficient water-in-oil emulsion. The aim of this study was therefore to evaluate the stability of a highly concentrated solution of epirubicin for cTACE and verify whether epirubicin solution could be prepared in advance.nnnMATERIALS AND METHODSnFifty milligrams of epirubicin were dissolved in 6 mL of 0.9% sodium chloride and conditioned in brown polypropylene syringe. Physical and chemical stability assays including particles and HPLC-DAD analysis were performed in triplicate, using series of 5 syringes stored over 72 h at 4±2 °C followed by 4h at 22±4°C.nnnRESULTSnNeither weight loss nor pH or spectrum change occurred. No haze or turbidity was observed and the number of subvisible particles was below the recommended limits. Epirubicin concentration remained above 95% of the initial value over the 72 h of storage at +4 °C followed by 4h at 22±4 °C and no degradation was observed.nnnCONCLUSIONnEpirubicin at 50mg/6 mL in 0.9% NaCl conditioned in brown propylene syringe is stable for at least 72 h at 4±2 °C with additional 4h at 22±4 °C allowing its preparation in advance for programmed cTACE and the standardization of its use in clinical practice.

mediEVAL : un nouvel outil d’évaluation de la prise en charge médicamenteuse

PURPOSESnA new methodology to evaluate the medication-use system based on a risk cartography tool, has been developed. This work has been promoted by the Observatoire du médicament et des dispositifs médicaux stériles et de linnovation thérapeutique (OMEDIT) from Provence-Alpes-Côte dAzur (PACA)-Corse regions.nnnMETHODSnThis new methodology has been developed with Excel (Microsoft(®)) and has led to the mediEVAL tool. It consists in two categories of Excel files: evaluating Excel files (1 for each job of the medication-use system) and synthesis Excel files which allow to compile a group of evaluating files for a defined area (department, hospital…).nnnRESULTS AND CONCLUSIONnmediEVAL is a new tool to evaluate quality and risk management of the entire medication-use system which has to be used by private or public hospitals of PACA and Corsica areas in their appropriate medication-use contract. Then, the OMEDIT can get data to provide an inventory of fixtures of the PACA-Corse area medication-use system situation.