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The article reports on the role of the nurse coordinator in a program recovery. It notes that most patients arrive in a state of stress related to the recent discovery of cancer. It adds that one needs to reduce the impact of surgery on stress physical and psychological as well as pain. It adds that one should promote its recovery and its autonomy to anticipate and secure his return home.

Objectives Orodispersible films ( ODF) were formulated to facilitate tetrabenazine ( TBZ) administration to paediatric population for the treatment of hyperkinetic movement disorders. Methods ODF were obtained by solvent casting/evaporation method using four different polymers ( HPMC, PVP, pullulan and HEC). Physicochemical, mechanical and biopharmaceutical characterizations as well as API state in ODF by thermal analysis were investigated to define and compare formulations. ODF stability was also monitored during 6 months to follow evolution of properties. Key findings Analyses at T0 showed few differences between formulations: results of physicochemical and mechanical characterizations were almost similar for each formulation and TBZ appeared at the amorphous state in all cases. ODF delivery system allowed a major improvement of TBZ dissolution profile in buccal conditions compared with pure drug. However, after 3 and 6 months of stability, a TBZ recrystallization occurred for formulations based on PVP and HEC associated with a decrease of drug release in saliva conditions. Conclusions HPMC- ODF (F1) appeared as the best formulation. Indeed, physicochemical, mechanical and biopharmaceutical characteristic remained intact. In addition, TBZ remained in amorphous state during stability study. [ABSTRACT FROM AUTHOR]

A common method used to prepare polymeric nanoparticles in pharmaceutical technology is emulsion-diffusion. However, this method has several disadvantages due to the long duration of the process. At the diffusion step of conventional emulsion-diffusion, high pressure treatment could replace the addition of great quantities of water resulting in diffusion of the solvents from the internal phase to the external phase. The objective of the present study was to develop a novel method for nanoparticle formulation by combining high pressure treatment with the emulsion-diffusion method to avoid an additional diffusion step in the aqueous phase. After emulsification at 11 000 rpm, the emulsions were pressurized at 100, 200 and 300 Mpa, each for 300, 600, 900 or 1200 s. The mean size and morphology of the nanoparticles were analysed by Mastersizer®, TEM and SEM. The mean size of pressurized emulsion nanoparticles was the same at 100 MPa for holding times up to 600 s. Also, the pressurized emulsion nanoparticle size increased and the peak and width of the size distribution curve was higher and slightly narrower depending on the pressure and the holding time. This study shows that pressure treatment can produce polymer membranes surrounding the oil surface owing to the precipitation of PCL, inducing the diffusion of solvent from the interior to the exterior based on TEM images. From these results, it is believed that high pressure treatment should be considered as a successful alternative for preparing nanoparticles. [ABSTRACT FROM AUTHOR]

Pectin beads containing β-lactamases were designed for the hydrolysis of colonic residual antibiotics responsible for the emergence of resistance. Beads were prepared by ionotropic gelation in CaCl2 and stabilized by coating with polyethylenimine (PEI) to resist disintegration in the upper GI tract. Particle characterization showed that dried beads had a diameter around 1 mm independently of the presence of PEI. Seven to ten percent (w/w) of PEI was located on bead surface forming a coating layer as observed by scanning electron microscopy. PEI improved considerably bead stability in simulated intestinal medium while affecting slightly the encapsulation efficiency of active β-lactamases. Coated beads were able to preserve β-lactamases from premature leakage in the upper GIT whereas, in simulated colonic medium, pectinases induced matrix degradation and reduction of β-lactamase content especially in beads coated in a 0.8% PEI solution. Finally, the pharmacokinetics of amoxicillin in rat after oral administration was not modified by the co-administration of beads containing β-lactamases. In conclusion, PEI-coated beads are stable in the upper GIT but remain sensitive to the action of pectinolytic enzymes allowing release of β-lactamases in a colonic medium without modification of the absorption of a β-lactam antibiotic when co-administered with loaded beads. © 2007 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 97: 1853–1863, 2008 [ABSTRACT FROM AUTHOR]

Neuroendocrine diseases are a heterogeneous group of entities with the ability to take up amine precursors, such as L-DOPA, and convert them into biogenic amines, such as dopamine. Congenital hyperinsulinism of infancy (HI) is a neuroendocrine disease secondary to either focal adenomatous hyperplasia or a diffuse abnormal pancreatic insulin secretion. While focal hyperinsulinism may be reversed by selective surgical resection, diffuse forms require near-total pancreatectomy when resistant to medical treatment. Here, we report the diagnostic value of PET with [18F]fluoro- L-DOPA in distinguishing focal from diffuse HI. Forty-nine children were studied with [18F]fluoro- L-DOPA. A thoraco-abdominal scan was acquired 45–65 min after the injection of 4.2 ± 1.0 MBq/kg of [18F]fluoro- L-DOPA. Additionally, 12 of the 49 children were submitted to pancreatic venous catheterisation for blood samples (PVS) and 31 were also investigated using MRI. We identified abnormal focal pancreatic uptake of [18F]fluoro- L-DOPA in 15 children, whereas diffuse radiotracer uptake was observed in the pancreatic area in the other 34 patients. In children studied with both PET and PVS, the results were concordant in 11/12 cases. All patients with focal radiotracer uptake and nine of the patients with diffuse pancreatic radiotracer accumulation, unresponsive to medical treatment, were submitted to surgery. In 21 of these 24 patients, the histopathological results confirmed the PET findings. In focal forms, selective surgery was followed by clinical remission without carbohydrate intolerance. These data demonstrate that PET with [18F]fluoro- L-DOPA is an accurate non-invasive technique allowing differential diagnosis between focal and diffuse forms of HI. [ABSTRACT FROM AUTHOR]