[Guidelines relative to the collection and handling management of biological samples].

Guidelines relative to the management of samples collection and handling for common tests are proposed with a list of websites to improve knowledge concerning the practices of biological sampling. Then, methodology is given for the creation of an electronic primary sample collection manual for medical laboratory tests. A list containing the medical laboratory tests for which the information and/or particular documents are needed either for the request or interpretation is presented.

[Guidelines for the order process of medical laboratory tests].

This document presents the requirements enumerated in the ISO 15189 standard to make reliable the formulation of a medical laboratory test order. The contents and the filling conditions of the request laboratory tests form are described, to clarify the interest of the information required. The purpose is to help to construct a specific formulation allowing the adequate realization of the laboratory tests but also to collect the needed clinical information essential to allow a relevant interpretation of the results with a goal of improvement of patient care.

[Guidelines for medical prescription of medical laboratory tests].

The implementation of a computer-assisted prescription is interesting for the laboratory to achieve requirements of NF EN ISO 15189 standard. The test redundancies are also studied and guidelines, founded on validated studies, are proposed. Some solutions concerning the management of orally-formulated prescriptions are given.

6-tioguanine monitoring in steroid-dependent patients with inflammatory bowel diseases receiving azathioprine.

Background: 6-Thioguanine (6-tioguanine) nucleotides are the active metabolites of azathioprine.

Aim: The aim of the study was to evaluate the rate of clinical remission without steroids in steroid-dependent Crohn's disease and ulcerative colitis patients receiving azathioprine, the medium- and long-term efficacy and the predictive factors of clinical response when monitoring 6-tioguanine.

Methods: Steroid-dependent Crohn's disease and ulcerative colitis patients receiving either azathioprine or not (treated later with a daily dose of 2.

Drug interaction between infliximab and azathioprine in patients with Crohn's disease.

Background: A drug interaction has been observed between infliximab and methotrexate in rheumatoid arthritis.

Aim: To look for an interaction between infliximab and azathioprine in Crohn's disease patients using the active metabolites of azathioprine: 6-tioguanine nucleotides.

Methods: Patients receiving azathioprine who required infliximab for ileo-colonic or ano-perineal Crohn's disease were recruited prospectively.

Pharmacokinetics of intrarectal nalbuphine in children undergoing general anaesthesia.

The pharmacokinetics of nalbuphine (0.3 mg/kg) administered by the rectal route were studied in ten children undergoing general anaesthesia for minor surgery. Blood sampling was carried out for 8 h after rectal administration and plasma drug concentrations were measured by high performance liquid chromatography using electrochemical detection after an optimized solid-phase extraction procedure.

[Hematotoxicity caused by azathioprine genetically determined and aggravated by xanthine oxidase deficiency in a patient following renal transplantation].

Azathioprine is an immunosuppressor used with ciclosporin and corticosteroids after organ transplantation. Azathioprine is rapidly transformed into 6-mercaptopurine which in turn is metabolized by three competitive pathways: a) intracellular hypoxanthine guanine phosphoribosyl transferase leads to 6-thioguanine nucleotides which can damage chromosome DNA; b) thiopurine methyltransferase produces inactive methylated derivatives; c) xanthine oxidase produces thiouric acid. Due to inter-individual variations in the later two pathways, azathioprine dose must be adapted to each patient.

Rapid and sensitive high-performance liquid chromatographic assay for nalbuphine in plasma.

A simple and reliable reversed-phase high-performance liquid chromatographic method with adequate internal analog standardization and coulometric detection is described for the quantification of nalbuphine in plasma samples. The lower limit of detection was estimated to be 0.1 ng/ml.

Pharmacokinetics of apomorphine in parkinsonian patients.

Apomorphine, a dopamine agonist, has been used efficiently in parkinsonian patients to treat severe levodopa-induced on-off phenomenon. Motor improvement has been obtained both with continuous subcutaneous (SC) infusions, and multiple SC injections. So as to assist in the understanding of the clinical results, we studied the peripheral pharmacokinetics of apomorphine in 20 patients after intravenous (IV) or SC injections in the anterior abdominal wall and in the thigh at various doses, or SC infusion.

[Pharmacokinetics of methohexital given by constant rate intravenous infusion].

The pharmacokinetic characteristics of a constant rate methohexitone infusion were studied in young ASA 1 patients undergoing maxillofacial surgery. They were randomly assigned to two groups; group M patients (n = 7) were given 9 mg.kg-1.

Relation between plasma concentration and clinical efficacy after sublingual single dose apomorphine in Parkinson's disease.

Five patients with Parkinson's disease were given a single sublingual dose of apomorphine in 3 mg tablets (2 patients received 18 mg and 3 patients took 39 mg). The therapeutic effect appeared within 33.0 min and lasted 137 min.

Determination of 6-mercaptopurine and its metabolites in plasma or serum by high performance liquid chromatography.

A sensitive and accurate reversed phase liquid chromatographic assay was developed for the determination of 6-mercaptopurine (6MP) (the active metabolite of azathioprine) in human plasma. The assay involved extraction into acetonitrile and dichloromethane from plasma pretreated with 0.038 M of dithiothreitol solution.

CSF drug levels for children with acute lymphoblastic leukemia treated by 5 g/m2 methotrexate. A study from the EORTC Children's Leukemia Cooperative Group.

A multicenter EORTC study was conducted in children with acute lymphocytic leukemia to determine whether 5 g/m2 of methotrexate (MTX) (24 h i.v. infusion, four cycles) is an appropriate dosage for obtaining CSF drug concentrations approaching the critical cytotoxic level of 10(-6) M.

Bayesian estimation of cyclosporine clearance in bone marrow graft.

The dosage regimen of cyclosporine (CsA) can be individualized in patients by means of a test dose (TD) method in the few days before bone marrow graft. To simplify the test dosing protocol, we used a Bayesian estimation (BE) of CsA clearance requiring population data and partial kinetic information for a given patient. In the first part, 42 patients, aged 11-47 years, were given a 2-h infusion of CsA (4 mg.

[Pharmacokinetic of cyclosporin A].

Pharmacokinetic studies of 13 children treated with cyclosporine A (CyA) were retrospectively analysed (9 renal transplants, 1 combined liver-kidney transplant, 1 heart transplant; 2 were treated for a nephrotic syndrome). The patients were separated into 2 groups: patients 0-15 years (group 1), patients 15-18 years (group 2). In comparison with adults (group 3), children of the 2 groups required higher CyA doses, related either to body weight or to body surface area.

Neurochemical actions of ethylketocyclazocine and ketocyclazocine in different regions of rat brain.

The effects of ethylketocyclazocine (EKC) and ketocyclazocine (KC), benzomorphan derivatives proposed as kappa opioid receptor agonists, were studied by measuring changes in the levels of dopamine (DA), noradrenaline (NA), 5-hydroxytryptamine (5-HT), and their major metabolites, DOPAC, HVA, MHPG-SO4, 5-HIAA, in different regions of rat brain. Doses ranging from 1 to 10 mg/kg were tested. EKC decreased the levels of DOPAC and HVA in striatum, and increased DA concentrations, EKC markedly increased the levels of MHPG-SO4 in hypothalamus, but not in cortex, midbrain and pons-medulla.

[The role of serotonin in the behavioral changes induced in the rat by cyclazocine].

Cyclazocine is a benzomorphan derivative, considered as a mixed kappa and and sigma opioid receptor agonist. In experimental study with rats, cyclazocine is known to increase locomotor activity and to produce a bizarre behavioral syndrome including head swaying, backward walking, circling. The present study was undertaken to investigate the effects of various drugs modifying the serotoninergic neuronal systems, upon the locomotor activity and the abnormal behaviors induced by cyclazocine.