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Introduction: Citrulline is an amino acid that becomes essential in situations of intestinal insufficiency such as short bowel syndrome. It is therefore interesting to provide the patients with dosage forms for routing citrulline to the colon. The aim of this work is to formulate microspheres of citrulline for colonic targeting by the technique of spray drying., Material and Methods: Eudragit(®) FS 30D was selected as polymer to encapsulate citrulline using the spray drying technique. Citrulline and Eudragit(®) FS 30D were dissolved in water and ethanol, respectively. The aqueous and the ethanolic solutions were then mixed in 1:2 (v/v) ratio. Microspheres were obtained by nebulizing the citrulline-Eudragit(®) FS 30D solution using a Mini spray dryer equipped with a 0.7mm nozzle. The microspheres have been formulated using citrulline and Eudragit(®) FS 30D. The size distribution of microspheres was determined by light diffraction. The morphology of the microspheres was studied by electron microscopy. Manufacturing yields, encapsulation rate and dissolution profiles were also studied., Results and Discussion: The microspheres obtained had a spherical shape with a smooth surface and a homogeneous size except for the microspheres containing the highest concentration of polymer (90 %). The formulation showed that the size and morphology of the microspheres are influenced by the polymer concentration. Manufacturing yields were about 51 % but encapsulation rate were always very high (above 90 %). The in vitro dissolution study showed that the use of the Eudragit(®) FS 30D under these conditions is not appropriate to change the dissolution profile of the citrulline., Conclusion: This technique has led to the formulation of microspheres with good physical properties in terms of morphology and size. The compression of the microspheres should help to control citrulline release for colonic targeting., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.) more...

Introduction: Drugs' administration via feeding tubes is a potential source of iatrogenic events for the intensive care patients because of the problem of not adapted galenic forms., Objectives: We analyzed the prescriptions of patients with enteral feedings to determine if the galenic forms were compatible with administration via feeding tubes. We also observed and analyzed the methods of drugs passage by nurses., Patients and Methods: We analyzed 30 prescriptions of patients with enteral feedings in the intensive care unit of Habib Bourguiba Sfax hospital, by a prospective and exhaustive way. We also, observed and evaluated the practices of preparation and administration of drugs to these patients via feeding tube by nurses., Results: Only 12% of drugs were liquids. Eighty-eight percent of the drugs were pulverised and capsule open before administration. The galenic form was not in conformity for 20% of drugs because of the prohibition to crushing tablet or opening capsule (gastroresistant form was dissolved), or because of the administration of a parenteral form (risk of irritation). Among 78 drugs administered by 10 different nurses, the time between passage of the drug and enteral nutrition were not respected for 59% of the observations. The drugs were managed in mixture for 90% of the observations. The gloves were not worn in 80% of observations. No rinsing is made between consecutive administrations and before administration., Conclusion: This study shows that it is possible to reduce risk of administration errors in the intensive care unit and to facilitate the administration of drug via feeding tube by prescribing liquid oral form or soluble solid oral form. It also shows the need for cooperation with the pharmacist in order to adapt the galenic forms and to redact protocol of administration., (Copyright © 2012 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.) more...

Background: The regularity of a compressive knit is defined as its ability to perform its function in a burnt skin. This property is essential to avoid the phenomenon of rejection of the material or toxicity problems But: Make knits biocompatible with high burnet of human skin., Methods: We fabric knits of elastic material. To ensure good adhesion to the skin, we made elastic material, typically a tight loop knitted. The Length of yarn absorbed by stitch and the raw matter are changed with each sample. The physical properties of each sample are measured and compared. Surface modifications are made to these samples by impregnation of microcapsules based on jojoba oil., Results: Knits are compressif, elastic in all directions, light, thin, comfortable, and washable for hygiene issues. In addition, the washing can find their compressive properties. The Jojoba Oil microcapsules hydrated the human burnet skin. This moisturizer is used to the firmness of the wound and it gives flexibility to the skin., Conclusion: Compressive Knits are biocompatible with burnet skin. The mixture of natural and synthetic fibers is irreplaceable in terms comfort and regularity. more...

The Human Genome Project improves our understanding of the molecular genetics basis of the inherited and complex diseases such as diabetes, schizophrenia, and cancer. Information from the human genome sequence is essential for several antenatal and neonatal screening programmes. The new genomic tools emerging from this project have revolutionized biology and medicine and have transformed our understanding of health and the provision of healthcare. Its implications pervade all areas of medicine, from disease prediction and prevention to the diagnosis and treatment of all forms of disease. Increasingly, it will be possible to drive predisposition testing into clinical practice, to develop new treatments or to adapt available treatments more specifically to an individual's genetic make-up. This genomic information should transform the traditional medications that are effective for every members of the population to personalized medicine and personalized therapy. The pharmacogenomics could give rise to a new generation of highly effective drugs that treat causes, not just symptoms. more...

Unlabelled: The aim of the study was to examine the influence of age at diagnosis of Crohn's disease on disease site and course in Tunisian patients., Methods: All hospital patients for Crohn's disease between 1993 and 2002 were included. They were segregated by age at diagnosis as follows: younger than 20 years, 20-39 years, and 40 years or older. And all patients were classified at the time of the latest visit into one of three subtypes of disease (non complicating, stricturing, and fistulizing) according Vienna's classification. Crohn's disease was devised also by site (ileum, ileocecal, colon and higher site)., Results: Sixty one patients (50.4%) were 20-39 years old and 43 patients (35.5%) were 40 years and older. Colonic involvement was significantly more common (46,5%) in the 40 years and older group compared with 20-39 years group (24.6%) (p = 0.01). The subtype without complication was significantly more common (58.1%) in the 40 years and older group compared with 20-39 years group (39.3%) (p = 0.05). The frequency of the need for surgery for any indication for Crohn's disease didn't differ significantly according to age., Conclusion: In this study, Crohn's disease diagnosed in tunisian patients that were 40 years and older had often a colonic site and a less severe phenotype supporting the concept of genetic heterogeneity. more...

Unlabelled: The aim of our study was to determine demographic, clinical, biological or endoscopic factors that predict intestinal stenosis in Crohn's disease., Patients and Methods: One hundred and twenty one patients were retrospectively analyzed during 10 years. The diagnosis of stenosis were determined by morphologic and endoscopic exams independently of appearance of symptoms. The studied characteristics were age at appearance of symptoms, sex, geographical origin, tobacco addiction, symptoms revealing Crohn's disease, extra-digest and auto-immune signs associate and seat of disease. Biological values studied were: haemoglobin, white cells, platelet, erythrocyte sedimentation rate, C- reactive protein and albumin. Predictive factors were assessed using univariate and multivariate analysis., Results: Forty-seven patients (38,8%) had a stenosis. In univariate analysis, predictive factors of stenosis were a young age and ileum site of Crohn's disease. In multivariate analysis, none of these variables was independently associated of appearance of stenosis in Crohn's disease., Conclusion: This study didn't identify the presence of predictive factors of intestinal stenosis in Crohn's disease that could allow an early specific therapy. more...

Parenteral nutrition is actually a known method of administration of nutriments but not without risk. During the compounding of parenteral nutrition (PN) mixtures, the most pharmaceutical problem is the addition of calcium and phosphates. Since this two minerals can form insoluble precipitate that will lead to catheter occlusions and/or pulmonary emboli. Several reports has been related about suspect deaths following a PN infusion contaminated by precipitates or particles, this situation led the Food and Drug Administration (FDA) to recommend the use of filters. The precipitation of calcium phosphate is not easily predictable when the concentrations of these two salts are high and this situation constitute one of the major danger that can destabilise the parenteral nutrition admixture. Although such events still appear to be rare, it should be possible to eliminate them with improved pharmaceutical practice. more...

The authors make a retrospective study of a series of 140 patients aged 59 years in average, followed up from 1995 to 2002 for adenocarcinoma of the stomach. Surgical resection was performed in 79 percent of the patients with total gastrectomy in 15.4%, partial gastrectomy in 50.6%. Resection was considered as curative in 66%. Lymph node metastases were present in 42, 9 percent of the patients. Margins of resection were involved in 24, 5% of the specimens. The mean survival rate was 26.5 months, 13 months and 5 months after curative resection, palliative resection and without resection. more...

Secondary amyloidosis is caused by the extracellular store of the fragment AA of the circulatory protein in serum amyloid-A. It can complicate diseases such as family mediterranean fever, rheumatoid arthritis or Crohn's disease. Renal amyloidosis is a rare but serious complication of Crohn's disease. We report two cases of Crohn's disease associated with a nephrotic syndrome due to renal amyloidosis. It is important to recognize this complication, especially since Colchicine has been proposed as a possible treatment. So, the search for proteinuria seems to be important for an early diagnosis of renal amyloidosis in Crohn's disease. more...

Weak therapeutic responses and weak immune cytotoxic CD8 and CD4 response in chronic hepatitis B emphasize the necessity to find new therapeutic strategies especially as specific immunotherapy. Vaccination, whose principle was to widen immune repertoire, was used as a curative treatment of chronic hepatitis B. It would be the therapeutic procedure with the lowest cost and the potentially greatest benefit. Our purpose was to enhance the interest of therapeutic vaccination in chronic hepatitis B in order to debate later its usefulness in developing countries. more...

The aim of this work was to study theophylline dissolution and diffusion from a compressed ethylcellulose matrix through an artificial membrane. The sustained release tablets were manufactured manufactured by direct compression. Dissolution and diffusion studies were performed using an absorption simulator. In the donor compartment, different pH media were used: i) 1.2, 5, 6, ii) the same media supplemented with 10% glucose and iii) an amino acid medium. The receiver medium was held at pH 7.4. The Higuchi equation was used to elucidate the dissolution mechanism. Results showed that dissolution was mainly influenced by theophylline solubility with a mechanism based on diffusion. Diffusion rate was assessed by calculating the diffusion coefficients. Diffusion was essentially dependent on rate of theophylline release. more...