The most prevalent pathology was lung cancer (19 CT, 14 of which were non-small cell lung cancer) and melanoma (four CT). Conclusion The CT are an opportunity to contain pharmaceutical costs in hospitals. Patients in CT produced a cost saving of C ¼ 3,482,662/year. The potential savings justify the need to incorporate as many clinical trials as possible, not just for cost savings but because it would mean better access for patients to these highly effective and/or breakthrough therapies.
<p>The residential sector is the leading electricity consumer in France, representing more than one-third of the final electricity uses. As a major contributor to the energy demand, this sector must implement a pathway to reduce energy demand and greenhouse gas emissions. However, the relevance of related policies may depend on the correct estimation of the evolution of future Residential Electricity Consumption (REC) under future climate. Future REC has already been studied at the national scale. However, since the important determinants of the future REC, such as evolution in the use of AC and the meteorological conditions, especially the temperature, have a large geographical variability, REC should be studied locally. To project the French REC in a warmer climate at a fine spatial scale, a linear thermosensitivity model fitted by annual observed electricity consumption data and historical temperature is applied at the smallest French geographic census unit named Ilots Regreoup&#233;s pour l'Information Statistical (IRIS), which divides the territory into meshes of about 2000 inhabitants per unit cell. Once the current electricity sensitivity is fitted for each IRIS, the future REC is computed by applying the model to temperature projections under climate change scenario RCP8.5 up until 2100 based on 5 CORDEX climate simulations. At the same time, extreme cases of two non-climatic factors related to the use of Air-Conditioning (AC, the AC adoption rate and electricity sensitivity in cooling conditions) are also studied for future cooling needs. If only the temperature evolves, the results show that the future REC should decline with decreasing heating needs in most cells but with spatial variability and an increase in the REC for some cells. Results also show a larger disparity within administrative regions containing between a few hundred and a few thousand IRIS than between administrative regions, which justifies that future REC studies based on climate projections should be studied locally. Including AC scenarios may modify the REC negative trend in more parts of France: the REC is expected to increase in the South-East. Such an increase in electricity demand due to AC usage may have detrimental effects, not only because the total REC may increase by 4\% by 2040 and even 45\% until 2100 under the most extreme AC scenario and should thus emit more greenhouse gas, but also because the use of AC is expected to increase outdoor temperature and the heat island effect. Further studies need to focus on alternative solutions to improve inhabitants' comfort during heat waves, such as large-scale urban greening and white-coated buildings, to reduce potential AC uses, especially for the regions that may face an increase in REC. Also, the thermal performance of the building, as well as the energy efficiency of AC appliances, need to be improved in those regions. Our study can help quantify the range of improvement needed to maintain at least energy demand for cooling unchanged in a warmer climate.</p>
partially used and perforated with a plastic spike, not PFL at room temperature. Material and methods The stability study was performed by high performance liquid chromatography coupled to a photodiode array detector. The method was validated according to the International Conference on Harmonisation guideline Q2 (R1). Physical stability was evaluated by visual and subvisual inspection. pH values were measured. Results PDA solutions PFL in D5W at 3 and 12 mg/mL retained more than 95% of the initial concentration after 7 days at 25°C and after 28 days at 2-8°C. PDA ready to dilute 25 mg/mL solutions PFL retained >95% of the initial concentration after 28 days at 25°C and 2-8°C. PDA solutions in D5W at 3 mg/mL and 12 mg/mL and PDA ready to dilute 25 mg/mL solutions not PFL retained >95% of the initial concentration after 7 days at room temperature. All samples had a pH in the range 8.05-8.77. A very light colouration, described in summary of product characteristics, to a more intense yellow-brown colouration, appeared depending on concentration and time. No precipitate was observed. Conclusion and relevance According to the manufacturer's specifications (colourless to slightly brown-yellow) and to the chemical stability, defined as >95% of the initial concentration, PDA solutions in D5W at 3 and 12 mg/mL and PDA ready to dilute 25 mg/mL solutions PFL were stable for 7 days at 25°C and for 28 days at 2-8°C. PDA solutions in D5W at 3 and 12 mg/mL and PDA ready to dilute 25 mg/mL solutions not PFL were stable for 7 days at room temperature.
Introduction Mitotane (o, p′-DDD) is a molecule that was developed many years ago for adrenal cortical carcinoma, but no suitable pediatric dosage form is available for administration to young children. Mitotane requires therapeutic drug monitoring because of its long half-life and difficulty in stabilizing plasma concentrations. Furthermore, Mitotane is a highly lipophilic drug that requires concurrent lipid administration. Case report We present the case of a 3-year-old girl who was diagnosed with metastatic adrenal cortical carcinoma. Due to the difficulty in administering the tablets and the non-stabilized mitotane dosages, a nasogastric tube was inserted. An administration protocol based on dispersing the tablets in whole milk was established by the pharmacy team. This led to the stabilization of the disease for at least 1.5 years. Management and outcome Mitotanemia is difficult to stabilize even when treatment is administered orally. To maintain biological efficacy, we propose an easily reproducible protocol. The efficacy was stabilized at a dosage of 1500 mg per day. Mitotanemia fluctuated between 14 mg/mL, and 20 mg/mL. The implementation of this protocol prevented treatment discontinuation. Discussion The administration of narrow therapeutic range drugs via a nasogastric tube is a challenge for healthcare teams, particularly in pediatric patients. Based on the findings of this clinical case, clinicians should consider future use of this protocol. The use of whole milk as a vehicle for mitotane is a simple, effective, and reproducible method to administer the drug to pediatric patients and can be used for other similar cases.
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