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Introduction: Admission of metastatic cancer patients to the intensive care unit (ICU) poses medical and ethical challenges in the absence of reliable prognostic tools to guide decision-making. Material and Methods: We retrospectively analyzed the medical charts of 129 consecutive patients with metastatic solid tumors admitted to the ICU between January and September 2014 and identified prognostic factors (PFs) using Cox models. Results: The mean patient age at ICU admission was 58.9 years (range, 25–81 years; males, 51%). Performance status (PS) was 0–1 and 2–3 in 61% and 39% of the patients, respectively. The most prevalent cancers were lung cancer (20%), sarcoma (17%), and breast cancer (16%). ICU admission was attributable to the cancer itself (53%), cancer treatment toxicity (43%), and comorbidities (37%). The median overall survival (OS) after ICU admission was 2.6 months; 15% of the patients died during the ICU stay. Poor PFs for OS were PS >1 before ICU admission (p = 0.007) and ICU admission for the cancer itself (p < 10−3). After ICU discharge, 58% and 42% of the patients received systemic treatment within 12 months and showed good PS recovery, respectively. Multiple organ failure and a multidisciplinary decision to limit therapeutic efforts were poor PFs for reinitiation of systemic treatment (p = 0.2 and 0.006, respectively), and the latter was also a poor PF for PS recovery (p = 0.004). Discussion: In the ICU, the OS of adult patients with solid tumors was similar to that of the noncancer population. For ICU admissions related to the cancer itself, the prognosis is poor.

Alors que le Venezuela est confronte a une severe crise de balance des paiements suite a la chute du prix du petrole, il apparait essentiel de comprendre les origines de cette situation. Cet article etudie tout d’abord les distorsions et les desequilibres economiques majeurs sous-jacents a cette economie, dont l’hyperinflation, pour ensuite evaluer la capacite du pays a faire face au risque de defaut de paiement. Nous construisons pour cela deux scenarios de besoin et capacite de financement, fortement dependants du prix du petrole et du soutien de la Chine. Ainsi nous montrons que, en l’absence d’un rebond tres important du prix du petrole, le defaut de paiement apparait inevitable. Enfin nous analysons la montee des tensions sociales et politiques qui accompagnent ce contexte economique degrade.Classification JEL : E31, F31, H63, O54, Q32.

Despite their early emergence in evolution, the protist dinoflagellates present similarities in cell cycle regulation with higher eukaryotes and yeasts. Using antibody directed against the p56edc13 of the fission yeast, we present evidence for the presence of a cyclin B homolog in the dinoflagellate Crypthecodinium cohnii. Biochemistry, immunofluorescence and electron microscopy show the continuous presence of the cyclin B homolog during the C cohnii cell cycle progression. Cyclin B, which appears to be exclusively cytoplasmic, is associated with a specific H1 kinase activity more active in M phase.

The eucaryote cell cycle is driven by a set of cyclin dependent kinases (CDKs) associated to cyclins, which confer not only the activity but also the substrate specificity and the proper localization of the kinase activity. In the fission yeast Schizosaccharomyces pombe, only one cyclin, the product of the cdc13 gene (p56cdc13), is required to be associated with p34cdc2, to control the complete cell cycle. Earlier studies have localized this complex mainly in the nucleus and its periphery. Using new improved electron microscopy (EM) technologies, based on high pressure freezing fixation, we refined previous studies, evidencing cytoplasmic localization of p56cdc13, in addition to the nuclear localization previously observed. Further immunofluorescence studies, performed on aldehydically fixed cells, confirmed our EM results, emphasizing the major cytoplasmic localization of p56cdc13 in interphase cells and the relocalization towards the nucleus in mitotic cells, suggesting that the S pombe cyclin B localization is cell cycle-regulated.

In order to determine if a mitotic spindle organizing center is present in dinoflagellate cells, we used a library of 12 monoclonal antibodies obtained by immunizing mice with isolated human centrosomes. When tested by immunofluorescence on cryosections of the dinoflaggelate Crypthecodinium cohnii B., a positive labeling was obtained with three of these antibodies. In interphase cells, the anti-centrosome antibodies labeled structures located either in the cell periphery, corresponding probably to both basal bodies (i.e. kinetosomes) and in the perinuclear area. In the latter case, two punctate structures were observed near the nuclear envelope. They have never been described, either in light, or in electron microscopic studies of dinoflagellates. We have designated them as centrosome-like structures. A microtubular desmose reacting positively with anti-tubulin Ab was also visible, linking kinetosomes and centrosome-like structures. During mitosis, the double punctate structures were observed at the poles of the nucleus. Double immunolabeling with tubulin and anti-centrosome Ab was also carried out and strongly suggested that in mitotic cells, centrosome-like structures, located at the poles of the mitotic spindle, were associated with microtubular bundles and probably organize and polarize them. These data indicate the existence of centrosome-like structures in C. cohnii cells and the strong conservation of some centrosomal epitopes from dinoflagellates to human. One of the antibodies (CTR 210) recognized by immunoblotting, a single protein band at 72 kDa from a total protein extract. The direct demonstration that this protein is located at the centrosome-like structures and at the kinetosomes deserves further study.

1. 1. Steady-state plasma level samples of sixty-five schizophrenic patients from two psychiatric hospitals assigned to three treatment groups (amitriptyline 150 mg/day, perphenazine 20 mg/day and a combination of amitriptyline and perphenmazine at 150 mg and 20 mg/day) were assayed for amitriptyline (AT), endogenous nortriptyline (NT) and perphenazine (PPZ) using gas-liquid chromatography. 2. 2. Results reveal that AT and NT levels are independent of sex and hospital environment. 3. 3. PPZ significantly increased the steady-state NT plasma levels, probably through inhibition of the hydroxylation biotransformation pathway, but had no effect on AT levels, thus indicating that PPZ has no influence on the desmethylation pathway, or alternatively, the hydroxylation of AT.

A comparative study of fluphénazine enanthate, a long-acting neuroleptic, fluphénazine bichlorhydrate and placebo was made on 28 chronic schizophrenics. The double-blind technique was possible by giving to the patients one of the three following treatments: the long-acting neuroleptic by injection every fortnight and placebo tablets daily, the standard neuroleptic (tablets) daily and regular injection of sesame oil or the two inactive substances in a similar way. Dosage of fluphénazine enanthate was 25, 50 or 75 mg every fortnight and of bichlorhydrate 10, 20 or 30 mg. daily after a fixed schedule. Antipsychotic action of the drugs was evaluated according to three types of measures: 1) IMPS; 2) NOSIE and 3) need for chlorpromazine given p.r.n. (indirect measure). Results of this study indicate that both fluphénazine salts are superior to placebo and possess significant antipsychotic properties as demonstrated by the indirect measure. No significant difference was found between enanthate and bichlorhydrate of fluphénazine. Some methodological aspects of psychopharmacological research are also discussed.