Pharmacy Education and Clinical Pharmacy Training in France.

Clinical pharmacy education varies widely between European countries, and several major changes have taken place in France. This review aims to describe the current state of pharmacy education in France, focusing on clinical pharmacy. Research into legislative texts on pharmacy education in France was conducted based on the national database "legifrance".

Use of clinical biological tests of haemostasis to evaluate topical haemostatics.

Introduction: In addition to traditional means, topical haemostatics are currently used to avoid haemorrhage during surgery. Although they have been reported to be effective, there is a low level of proof of their clinical efficacy, which is at odds with their levels of use. This study used two methods to better understand their in vitro mechanism of action.

Public Health Impact of Using Biosimilars, Is Automated Follow up Relevant?

Biologic reference drugs and their copies, biosimilars, have a complex structure. Biosimilars need to demonstrate their biosimilarity during development but unpredictable variations can remain, such as micro-heterogeneity. The healthcare community may raise questions regarding the clinical outcomes induced by this micro-heterogeneity.

Is the MitraClip® procedure profitable in a high-volume French hospital?

Background: Mitral regurgitation is the second most frequent valvulopathy managed by surgery in Europe. For patients who have a contraindication to surgery or a high surgical risk, the percutaneous MitraClip® implantation procedure has emerged as a favourable alternative approach, but elevated procedural costs are a medicoeconomic concern.

Aim: The objective of this study was to evaluate whether the MitraClip® procedure is profitable in a high-volume French hospital.

In vitro cytotoxic effects of secondary metabolites of DEHP and its alternative plasticizers DINCH and DINP on a L929 cell line.

Background: Phthalic acid esters are widely used to improve the plasticity of PVC in medical devices (MD). The most famous plasticizer is DEHP, whose use in medical devices has been contested by the European authorities since 2008. Several alternative plasticizers are being considered to replace DEHP, such as DEHT, TOTM, DINP or DINCH, but they are also released from the PVC throughout their life cycle and are metabolized in the same way as DEHP.

A comparative profitability analysis of transcatheter versus surgical aortic valve replacement in a high-volume French hospital.

Background: Current scientific guidelines have extended the indication for transcatheter aortic valve replacement (TAVR) to patients who present an intermediate risk for surgery and have been so far considered for conventional surgery. We previously demonstrated that the TAVR procedure generated profits despite elevated costs, but comparison with surgery has not been performed. The objective of this study was to assess the profitability of the TAVR procedure compared with conventional surgery in a high-volume French hospital.

Application of Millifluidics to Encapsulate and Support Viable Human Mesenchymal Stem Cells in a Polysaccharide Hydrogel.

Human adipose-derived stromal cells (hASCs) are widely known for their immunomodulatory and anti-inflammatory properties. This study proposes a method to protect cells during and after their injection by encapsulation in a hydrogel using a droplet millifluidics technique. A biocompatible, self-hardening biomaterial composed of silanized-hydroxypropylmethylcellulose (Si-HPMC) hydrogel was used and dispersed in an oil continuous phase.

Patients' exposure to PVC plasticizers from ECMO circuits.

Background: ECMO is a therapeutic act with a high risk of exposure to diethylhexylphthalate (DEHP), plasticizer from PVC tubings. The replacement of this plasticizer with alternative compounds is recommended but the risks associated with the use of new plasticizers have not been evaluated in ECMO situations.

Methods: Ex vivo ECMO models were performed with different flow rates over 6 days to evaluate the migration of plasticizers and their potential toxic risk for patient.

Is transcatheter aortic valve replacement a profitable procedure in a high-volume French hospital?

Background: Transcatheter aortic valve replacement (TAVR) has revolutionized the prognosis of inoperable patients with severe aortic valve stenosis. Yet, the implantation of expensive prostheses in patients with comorbidities may be questionable in an era when healthcare costs are becoming a major concern.

Aim: The objective of this study was to assess whether the TAVR procedure is profitable in a high-volume French hospital.

Polysaccharide Hydrogels Support the Long-Term Viability of Encapsulated Human Mesenchymal Stem Cells and Their Ability to Secrete Immunomodulatory Factors.

While therapeutically interesting, the injection of MSCs suffers major limitations including cell death upon injection and a massive leakage outside the injection site. We proposed to entrap MSCs within spherical particles derived from alginate, as a control, or from silanized hydroxypropyl methylcellulose (Si-HPMC). We developed water in an oil dispersion method to produce small Si-HPMC particles with an average size of about 68 m.

Biomaterial-assisted cell therapy in osteoarthritis: From mesenchymal stem cells to cell encapsulation.

Osteoarthritis (OA) is a degenerative and inflammatory joint disease that affects the cartilage, subchondral bone, and joint tissues. Although current drug therapies can provide a degree of symptomatic relief from pain, they fail to prevent joint damage. Mesenchymal stem/stromal cells (MSCs) have generated significant interest in terms of medical applications because they exert their therapeutic properties by secretion of bioactive factors that have potent immunomodulatory, antiapoptotic, antifibrotic, and anti-inflammatory effects.

The affordability of minimally invasive procedures in major lung resection: a prospective study.

Objectives: Minimally invasive procedures are used for the surgical treatment of lung cancer. Two techniques are proposed: video-assisted thoracic surgery or robotic-assisted thoracic surgery. Our goal was to study the economic impact of our long-standing program for minimally invasive procedures for major lung resection.

In vitro cytotoxic effects of DEHP-alternative plasticizers and their primary metabolites on a L929 cell line.

Phthalic acid esters have been widely used to improve the plasticity of PVC medical devices. They carry a high exposure risk for both humans and the environment in clinical situations. Our study focuses on the cytotoxicity of alternative plasticizers.

A cost-minimization analysis in minimally invasive spine surgery using a national cost scale method.

Introduction: The last decade has seen the emergence of minimally invasive spine surgery. However, there is still no consensus on whether percutaneous osteosynthesis (PO) or open surgery (OS) is more cost-effective in treatment of traumatic fractures and degenerative lesions. The objective of this study is to compare the clinical results and hospitalization costs of OS and PO for degenerative lesions and thoraco-lumbar fractures.

Cardiac remote monitoring in France.

The increase in number of implanted cardiac medical devices and the announced decrease in number of cardiologists have led to remote monitoring being considered as a pivotal tool for patient follow-up. For 10 years, remote monitoring has been the subject of multiple clinical studies. In these studies, reliability and clinical efficacy have been demonstrated, but the use of remote monitoring remains quite limited in France compared with other countries.

Clinical and economic evaluation of ambulatory endovascular treatment of peripheral arterial occlusive lesions.

Background: Ambulatory management of patients is an alternative to conventional hospitalization. In this study we evaluate the results of a prospective cohort study of patients receiving ambulatory endovascular treatment for peripheral arterial lesions.

Methods: From June 2008 to October 2010, ambulatory management was proposed for endovascular treatment of peripheral arterial lesions.

Laser-treated Nucleus pulposus as an innovative model of intervertebral disc degeneration.

This study describes an innovative experimentally induced model of intervertebral disc degeneration. This innovative approach is based on the induction of extracellular matrix disorders in the intervertebral disc (IVD) using a diode laser. For this study, 15 one-year-old and five 30-month-old New Zealand White rabbits were used.

[Impact of the use of luer access devices on the quality of chronic hemodialysis].

Luer access valves are medical devices used to reduce infectious risks by securing repetitive handling in chronic hemodialysis using central catheter. Their impact on the effectiveness of a hemodialysis session still remains poorly studied. This in vivo study aims to evaluate its effectiveness.

Assay of in vitro osteoclast activity on dentine, and synthetic calcium phosphate bone substitutes.

Resorption of synthetic bone substitute materials is essential for the integration of these materials into the natural bone remodeling process. Osteoclast behavior in the presence of calcium phosphate bioceramics (CaPB) is partially understood, and a better understanding of the underlying mechanisms is expected to facilitate the development of new synthetic bone substitutes to improve bone regeneration. In the present study, our aim was to investigate osteoclastic resorption of various synthetic CaPB.

Characterization of the age-dependent intervertebral disc changes in rabbit by correlation between MRI, histology and gene expression.

Background: The present study was conducted to address whether the intervertebral disc of rabbit could be considered (i) as a valuable model to provide new insights into the tissue and cellular changes of Nucleus pulposus aging and (ii) as an appropriate tool to investigate the efficacy of Nucleus pulposus cell-based biotherapies.

Methods: Lumbar intervertebral disc from rabbits with increasing ages (1, 6 and 30 month-old) were compared by MRI and histological observation using Pfirrmann's grading and Boos' scoring respectively. The expression of transcripts (COL2A1, AGC1, COL1A1, MMP13, BMP2, MGP and p21) in Nucleus pulposus cells were analysed by quantitative real-time PCR.

Identification of phenotypic discriminating markers for intervertebral disc cells and articular chondrocytes.

Objective: The present study was conducted to improve our knowledge of intervertebral disc (IVD) cell biology by comparing the phenotype of nucleus pulposus (NP) and annulus fibrosus (AF) cells with that of articular chondrocytes (ACs).

Methods: Rabbit cells from NP and AF were isolated and their phenotype was compared with that of AC by real-time PCR analysis of type I (COL1A1), II (COL2A1) and V (COL5A1) collagens, aggrecan transcript (AGC1), matrix Gla protein (MGP) and Htra serine peptidase 1 (Htra1).

Results: Transcript analysis indicated that despite certain similarities, IVD cells exhibit distinct COL2A1/COL1A1 and COL2A1/AGC1 ratios as compared with AC.

From osteoarthritis treatments to future regenerative therapies for cartilage.

Osteoarthritis (OA) is associated with cartilage degeneration and an accompanying inflammatory syndrome of the synovium in addition to alteration of the subchondral bone. The molecular and cellular events involved in OA have only partially been elucidated. This review provides a global view of the physiopathology of OA, as well as non-pharmacological and pharmacological treatments for the disorder.

Quantitative and reliable in vitro method combining scanning electron microscopy and image analysis for the screening of osteotropic modulators.

The increased generation and up-regulated activity of bone resorbing cells (osteoclasts) play a part in the impairment of bone remodeling in many bone diseases. Numerous drugs (bisphosphonates, calcitonin, selective estrogen receptor modulators) have been proposed to inhibit this increased osteoclastic activity. In this report, we describe a pit resorption assay quantified by scanning electron microscopy coupled with image analysis.