1,720,961 research outputs found
Optimisation de l'utilisation du tacrolimus chez le transplanté hépatique
No full textThe efficacy of immunosuppressive drugs has led to the development and success of liver transplantation. Indeed, use of calcineurin inhibitors, of which tacrolimus is the main drug, has allowed an important decrease in the frequency of immunological complications. On the other hand, the adverse effects associated with its use now represent a significant proportion of post-transplant morbidity. Based on this observation, the objective of our work was to optimize the use of tacrolimus in liver transplant recipient using innovative pharmacological methods and to explore the mechanisms of its toxicity. A first way of research was to evaluate a policy of extreme minimization of tacrolimus target blood trough concentration, thus confirming this therapeutic policy. The second part highlights the importance of the intra-patient variability of tacrolimus trough concentrations during the early phase as a marker of the occurrence of its adverse effects and of patient’s the long-term survival. Finally, the measurement of tacrolimus concentrations in bile provides us new hypotheses on the mechanisms of its toxicity. The results of these studies helped us to improve our clinical practice and to explore the mechanisms of tacrolimus toxicity.L’efficacité des traitements immunosuppresseurs a permis l’essor et le succès de la transplantation hépatique. Ainsi, l’utilisation des inhibiteurs de la calcineurine, dont le tacrolimus est le représentant principal, a permis une diminution drastique de la fréquence des complications immunologiques. En revanche, les effets indésirables liés à son utilisation représentent aujourd’hui une part importante de la morbidité posttransplantation. Partant de ce constat, l’objectif de notre travail était d’optimiser l’utilisation du tacrolimus chez les patients transplantés hépatiques à l’aide de méthodes pharmacologiques innovantes et d’explorer les mécanismes physiopathologiques de sa toxicité. Un premier axe de recherche a été d’évaluer une stratégie de minimisation extrême de la cible de concentration résiduelle sanguine du tacrolimus permettant ainsi de conforter cette attitude thérapeutique. Une seconde piste a permis de mettre en évidence l’importance de la variabilité intra-individuelle des concentrations de tacrolimus durant la phase précoce comme marqueur de la survenue de ses effets indésirables et de la survie à long terme des patients. Enfin, l’étude de la mesure des concentrations de tacrolimus dans la bile nous a permis d’apporter des pistes sur les mécanismes potentiels de sa toxicité. Les résultats de ces différents travaux nous ont donc permis d’améliorer notre pratique clinique et d’ouvrir plusieurs pistes dans la compréhension des mécanismes de la toxicité du tacrolimus
Optimisation of tacrolimus utilization in liver transplanted patients
No full textL’efficacité des traitements immunosuppresseurs a permis l’essor et le succès de la transplantation hépatique. Ainsi, l’utilisation des inhibiteurs de la calcineurine, dont le tacrolimus est le représentant principal, a permis une diminution drastique de la fréquence des complications immunologiques. En revanche, les effets indésirables liés à son utilisation représentent aujourd’hui une part importante de la morbidité posttransplantation. Partant de ce constat, l’objectif de notre travail était d’optimiser l’utilisation du tacrolimus chez les patients transplantés hépatiques à l’aide de méthodes pharmacologiques innovantes et d’explorer les mécanismes physiopathologiques de sa toxicité. Un premier axe de recherche a été d’évaluer une stratégie de minimisation extrême de la cible de concentration résiduelle sanguine du tacrolimus permettant ainsi de conforter cette attitude thérapeutique. Une seconde piste a permis de mettre en évidence l’importance de la variabilité intra-individuelle des concentrations de tacrolimus durant la phase précoce comme marqueur de la survenue de ses effets indésirables et de la survie à long terme des patients. Enfin, l’étude de la mesure des concentrations de tacrolimus dans la bile nous a permis d’apporter des pistes sur les mécanismes potentiels de sa toxicité. Les résultats de ces différents travaux nous ont donc permis d’améliorer notre pratique clinique et d’ouvrir plusieurs pistes dans la compréhension des mécanismes de la toxicité du tacrolimus.The efficacy of immunosuppressive drugs has led to the development and success of liver transplantation. Indeed, use of calcineurin inhibitors, of which tacrolimus is the main drug, has allowed an important decrease in the frequency of immunological complications. On the other hand, the adverse effects associated with its use now represent a significant proportion of post-transplant morbidity. Based on this observation, the objective of our work was to optimize the use of tacrolimus in liver transplant recipient using innovative pharmacological methods and to explore the mechanisms of its toxicity. A first way of research was to evaluate a policy of extreme minimization of tacrolimus target blood trough concentration, thus confirming this therapeutic policy. The second part highlights the importance of the intra-patient variability of tacrolimus trough concentrations during the early phase as a marker of the occurrence of its adverse effects and of patient’s the long-term survival. Finally, the measurement of tacrolimus concentrations in bile provides us new hypotheses on the mechanisms of its toxicity. The results of these studies helped us to improve our clinical practice and to explore the mechanisms of tacrolimus toxicity
L'alimentation entérale réduit le taux de gastroparésie après duodénopancréatectomie céphalique (analyse rétrospective de 275 interventions de Whipple avec reconstruction selon Child)
No full textLa gastroparésie (GP) est fréquente après duodénopancréatectomie céphalique (DPC). Le but de notre étude est d'évaluer l'influence de l'alimentation entérale (AE) sur la GP après DPC. Nous avons rétrospectivement analysé 275 patients opérés d'une DPC entre Janvier 2000 et Septembre 2009. Les patients opérés après Janvier 2005 avaient reçu une AE (groupe AE=152) contrairement aux patients opérés avant 2005 (groupe control=123). L'incidence de la GP était de 26% vs 38% (p=0.04) dans le groupe AE et le groupe contrôle, respectivement. L'incidence des hémorragies postopératoires (HP) était significativement réduite dans le groupe AE (8% vs 20%, p=0.008), celle des fistules pancréatiques était similaire dans les deux groupes (15% vs 12%; NS). La durée d'hospitalisation était également comparable (18+-11 vs 19+-13j; NS). En analyse multivariée, l'AE (p=0.047, OR=0.56), la durée opératoire (p<0,001, OR=1.007), et l'âge (p=0.014, OR=1.03) étaient des facteurs influençant l'incidence de la GP.RENNES1-BU Santé (352382103) / SudocSudocFranceF
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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