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Several steps in the replicative cycle of human immunodeficiency virus (HIV) could be envisaged as targets for anti-AIDS drugs. The anionic compound PMEA [9-(2-phosphonyl-methoxyethyl)adenine], the 2'3'-dideoxynucleoside analogues D4T (2',3-deidehydro-2',3'-dideoxythymidine), AzddUrd 3'-azido-2',3'-dideoxyuridine), FddUrd (3'-fluoro-2',3-dideoxyuridine), AzddDAPR (3'-azido-2',3'-dideoxy-2,6' diaminopurine riboside) and the sulfated polysaccharides dextran sulfate and pentosan polysulfate are among the most promising candidate anit-AIDS drugs which have been recently described. They are targeted at either virus-cell binding (dextran sulfate, pentosan polysulfate) or virus-associated reverse transcriptase (PMEA, D4T, AzddUrd, FddUrd, AzddDAPR).
Objectives: To measure the reliability of data mining for indicators related to patient treatment at hospital discharge.\n\nMethods: Design: Retrospective cohort study. Population: Patients discharged alive after an admission for heart failure in a general internal medicine department from 2009 to 2010. Data: Key treatments at patient's discharge extracted from the clinical information system compared with data extracted manually from the medical records. Endpoint: Accuracy of data mining for treatment prescription. Analysis: Sensitivity, specificity, positive and negative predictive values (PPVs and NPVs) of data mining for angiotensin-converting enzyme (ACE) inhibitors and betablockers prescription discharge. The gold standard was manual data extraction. We then investigated causes of discrepancies between the two methods.\n\nResults: A total of 724 patients were included. At discharge, 85.2% received an ACE inhibitor and 72.4% a beta-blocker. For ACE inhibitors, data mining yielded a sensitivity of 90%, a specificity of 100%, a PPV of 100% and an NPV of 64%. Corresponding values for beta-blockers were 95%, 100%, 100% and 88%, respectively. Main causes for discrepancy were: omission of some molecules in the electronic query used; non-standard writing of a prescription in the clinical information system; formats incorrectly interpreted by the query.\n\nConclusion: Immediate reliance on data mining for drug prescription is currently unwarranted because this complex process is still prone to errors. Results should be manually checked before they can be used as quality indicators.
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Methanolic extract of whole parts of Indigofera tinctoria have been studied against replication of HIV-1 (III B) and HIV-2 (ROD) in MT-4 cells.
New formamidine-3TC (3TC = 2',3'-dideoxy-3'-thiacytidine) analogues have been synthesized through various methods, and their antiviral activities (HIV, HBV) have been evaluated in vitro. Anti-HIV-1 in acutely infected MT-4 cells and peripheral blood monocellular cells (PBMCs) showed that compounds substituted by N,N-diarylformamidine side chains at the 4-N nucleic base position (compounds 3 and 8-11) had at least equivalent anti-HIV activity as 3TC (EC50 = 0.5 and 11.6 microM, respectively). Moreover, the newly synthesized compounds demonstrated higher anti-HBV activity (EC50 ranging from 0.01 to 0.05 microM) compared to the parent nucleoside 3TC (EC50 = 0.2 microM). It should be underlined that these new promising derivatives inhibited HIV in cells of a macrophage lineage, which are known to be cellular reservoir for HIV. These results were particularly of interest, since the antiviral activities appeared not to be mediated through the formamidine bond hydrolysis and consequently the release of free 3TC. These new analogue series were found to be highly stable to hydrolysis even after prolonged incubation in different biological media (t(1/2) ranged from 48 to 120 h). This enzymatic stability, coupled to the fact that no delay in the antiviral response was observed compared to the free 3TC antiviral response, suggest that this new N,N-diarylformamidine nucleoside series should not be considered as classical prodrugs.
A couple of years ago, the Belgian Federal Ministry of Health decided to back the development of a basic conceptual model for Electronic Patient Record (EPR) in primary care. Using consensus and modeling relational techniques, a working group of experts and experienced practitioners identified 7 key structuring concepts: Health Care Element, Health Approach, Contact, Subcontact, Service, Health Agent, Period. This model could roughly be seen as a restrictive sub-model of the current CEN proposal (prENV 13940) or as a first step to assess this CEN pre-Norm in Belgium. The conceptual model is already used in teaching activities and in a Belgian software labeling process.