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Le Garrec D, Chesnel C, Teng M, Lagnau P, Brouchet M, Chea M, Amarenco G, Hentzen C. [Intermittent catheterization: What are the environmental impacts and how can they be reduced?]. Prog Urol 2023; 33:533-540. [PMID: 37596127 DOI: 10.1016/j.purol.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/09/2023] [Accepted: 07/10/2023] [Indexed: 08/20/2023]
Abstract
INTRODUCTION If the use of intermittent catheterization has revolutionized the prognosis of neuro-urology patients, it seems necessary to question the ecological cost of single-use catheters, in a process of decarbonization of the health sector. The aim of this work is to identify the environmental impact of intermittent catheterization and potential solutions to reduce it. METHODS A review of the literature on the environmental impact of intermittent catheterizations was conducted. Potential solutions to reduce this impact and possible alternatives were then studied based on data from the literature. RESULTS Only two studies were identified. The first estimated the amount of waste generated by intermittent catheterization in the USA to be between 4400 and 38,964 tons per year. The second study showed a higher overall environmental impact of thermoplastic polyurethane (TPU) catheters than polyvinyl chloride (PVC) catheters and catheters made from polyolefin material. Reuse of catheters would reduce the amount of waste, but the paucity of data does not allow us to determine if the incidence of urinary tract infection would be affected. Alternative micturition methods, in addition to the complications they may cause, require the use of collection bags or pads, which also have an environmental impact. Other treatments for dysuria exist, but the evidence is limited and does not cover all patient populations. CONCLUSION With limited alternatives, it appears essential to develop more environmentally friendly catheters.
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Affiliation(s)
- D Le Garrec
- GRC 01, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne Université, 75020 Paris, France.
| | - C Chesnel
- GRC 01, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne Université, 75020 Paris, France
| | - M Teng
- GRC 01, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne Université, 75020 Paris, France
| | - P Lagnau
- GRC 01, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne Université, 75020 Paris, France
| | - M Brouchet
- GRC 01, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne Université, 75020 Paris, France
| | - M Chea
- GRC 01, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne Université, 75020 Paris, France
| | - G Amarenco
- GRC 01, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne Université, 75020 Paris, France
| | - C Hentzen
- GRC 01, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne Université, 75020 Paris, France
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Rigby-Jones AE, Sneyd JR, Ravenelle F, Vachon P, Le Garrec D, Gori S, Lessard D, Smith DC. Pharmacokinetics and anaesthetic effects of propofol-PM: a novel water soluble propofol formulation. Anaesthesia 2008. [DOI: 10.1111/j.1365-2044.2008.05646_1.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ravenelle F, Vachon P, Rigby-Jones A, Sneyd J, Le Garrec D, Gori S, Lessard D, Smith D. Anaesthetic effects of propofol polymeric micelle: a novel water soluble propofol formulation. Br J Anaesth 2008; 101:186-93. [DOI: 10.1093/bja/aen147] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Le Garrec D, Gori S, Luo L, Lessard D, Smith DC, Yessine MA, Ranger M, Leroux JC. Poly(N-vinylpyrrolidone)-block-poly(d,l-lactide) as a new polymeric solubilizer for hydrophobic anticancer drugs: in vitro and in vivo evaluation. J Control Release 2004; 99:83-101. [PMID: 15342183 DOI: 10.1016/j.jconrel.2004.06.018] [Citation(s) in RCA: 175] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2004] [Accepted: 06/19/2004] [Indexed: 10/26/2022]
Abstract
The majority of novel anticancer drugs developed to date are intended for parenteral administration. Paradoxically, most of these drugs are water-insoluble, delaying their clinical development. A common approach to confering water solubility to drugs is to use amphiphilic, solubilizing agents, such as polyethoxylated castor oil (e.g., Cremophor EL, CrmEL). However, these vehicles are themselves associated with a number of pharmacokinetic and pharmaceutical concerns. The present work is aimed at evaluating a novel polymeric solubilizer for anticancer drugs, i.e., poly(N-vinylpyrrolidone)-block-poly(D,L-lactide) (PVP-b-PDLLA). This copolymer self-assembles in water to yield polymeric micelles (PM) that efficiently solubilize anticancer drugs, such as paclitaxel (PTX), docetaxel (DCTX), teniposide (TEN) and etoposide (ETO). A PM-PTX formulation was evaluated, both, in vitro on three different cancer cell lines and in vivo for its safety, pharmacokinetics, biodistribution and antitumor activity. In vitro, cytotoxicity studies revealed that the drug-loaded PM formulation was equipotent to the commercial PTX formulation (Taxol). In the absence of drug, PVP-b-PDLLA with 37% DLLA content was less cytotoxic than CrmEL. In vivo, acute toxicity was assessed in mice after a single injection of escalating dose levels of formulated PTX. PM-PTX was well tolerated and the maximum tolerated dose (MTD) was not reached even at 100 mg/kg, whereas the MTD of Taxol was established at 20 mg/kg. At 60 mg/kg, PM-PTX demonstrated greater in vivo antitumor activity than Taxol injected at its MTD. Finally, it was shown in mice and rabbits that the areas under the plasma concentration-time curves were inversely related to PM drug loading.
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Affiliation(s)
- D Le Garrec
- Canada Research Chair in Drug Delivery, Faculty of Pharmacy, University of Montreal, C.P. 6128, Succ. Centre-ville, Montreal (Québec) Canada H3C 3J7
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Dufresne MH, Garrec DL, Sant V, Leroux JC, Ranger M. Preparation and characterization of water-soluble pH-sensitive nanocarriers for drug delivery. Int J Pharm 2004; 277:81-90. [PMID: 15158971 DOI: 10.1016/j.ijpharm.2003.07.014] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2003] [Revised: 05/17/2003] [Accepted: 07/19/2003] [Indexed: 10/26/2022]
Abstract
pH-sensitive drug delivery systems can be engineered to release their contents or change their physicochemical properties in response to variations in the acidity of the surroundings. The present work describes the preparation and characterization of novel polymeric micelles (PM) composed of amphiphilic pH-responsive poly(N-isopropylacrylamide) (PNIPAM) or poly(alkyl(meth)acrylate) derivatives. On one hand, acidification of the PNIPAM copolymers induces a coil-to-globule transition that can be exploited to destabilize the intracellular vesicle membranes. In this work, PNIPAM-based PM were loaded with either doxorubicin or aluminium chloride phthalocyanine and their cytotoxicity was assessed in murine tumoral models. On the other hand, poly(alkyl(meth)acrylate) copolymers can be designed to interact with either hydrophobic drugs or polyions and release their cargo upon an increase in pH.
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Affiliation(s)
- M-H Dufresne
- Canada Research Chair in Drug Delivery, Faculty of Pharmacy, University of Montreal, C.P. 6128, Succ. Centre-Ville, Montreal, Que., Canada H3C 3J7
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Le Garrec D, Taillefer J, Van Lier JE, Lenaerts V, Leroux JC. Optimizing pH-responsive polymeric micelles for drug delivery in a cancer photodynamic therapy model. J Drug Target 2002; 10:429-37. [PMID: 12442814 DOI: 10.1080/1061186021000001887] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Different pH-sensitive, randomly- and terminally-alkylated N-isopropylacrylamide (NIPAM) copolymers were synthesized and used to prepare pH-responsive polymeric micelles (PM). These copolymers were modified from previously-studied copolymers by incorporating an additional hydrophilic monomer, N-vinyl-2-pyrrolidone (VP) to decrease uptake by the mononuclear phagocyte system (MPS) and improve localization in tumors. VP lowered the phase transition pH of the copolymers but did not affect the onset of micellization. The in vitro cytotoxicity of the copolymers was evaluated on EMT-6 mouse mammary tumor cells in comparison to Cremophor EL (CRM). The anticancer photosensitizer aluminum chloride phthalocyanine (AlClPc) was loaded into the PM with a standard dialysis procedure. Biodistribution and in vivo photodynamic activity were then evaluated in Balb/c mice bearing intradermal EMT-6 tumors. All NIPAM copolymers demonstrated substantially lower cell cytotoxicity than the control surfactant CRM. In vivo, similar AlClPc tumor uptake was observed for the PM and CRM formulations. However, the PM appeared to exhibit greater activity in vivo than CRM formulation at an AlClPc subtherapeutic dose. Therefore, NIPAM-based copolymers containing VP units represent promising alternatives for the formulation of poorly water-soluble phthalocyanines.
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Affiliation(s)
- D Le Garrec
- Faculty of Pharmacy, University of Montreal, Que., Canada
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Leroux J, Roux E, Le Garrec D, Hong K, Drummond DC. N-isopropylacrylamide copolymers for the preparation of pH-sensitive liposomes and polymeric micelles. J Control Release 2001; 72:71-84. [PMID: 11389986 DOI: 10.1016/s0168-3659(01)00263-2] [Citation(s) in RCA: 141] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Hydrophobically-modified copolymers of N-isopropylacrylamide bearing a pH-sensitive moiety were investigated for the preparation of pH-responsive liposomes and polymeric micelles. The copolymers having the hydrophobic anchor randomly distributed within the polymeric chain were found to more efficiently destabilize egg phosphatidylcholine (EPC)/cholesterol liposomes than the alkyl terminated polymers. Release of both a highly-water soluble fluorescent contents marker, pyranine, and an amphipathic cytotoxic anti-cancer drug, doxorubicin, from copolymer-modified liposomes was shown to be dependent on pH, the concentration of copolymer, the presence of other polymers such as polyethylene glycol, and the method of preparation. Both polymers were able to partially stabilize EPC liposomes in human serum. These polymers were found to self-assemble to form micelles. The critical association concentration was low (9--34 mg/l) and influenced by the position of the alkyl chains. In phosphate buffered saline, the micelles had a bimodal size distribution with the predominant population having a mean diameter of 35 nm. The polymeric micelles were studied as a delivery system for the photosensitizer aluminum chloride phthalocyanine, (AlClPc), currently evaluated in photodynamic therapy. pH-Responsive polymeric micelles loaded with AlClPc were found to exhibit increased cytotoxicity against EMT-6 mouse mammary cells in vitro than the control Cremophor EL formulation.
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Affiliation(s)
- J Leroux
- Faculty of Pharmacy, University of Montreal, C.P. 6128 Succ. Centre-Ville, Montreal (Qc) H3C 3J7 Canada.
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Taillefer J, Brasseur N, van Lier JE, Lenaerts V, Le Garrec D, Leroux JC. In-vitro and in-vivo evaluation of pH-responsive polymeric micelles in a photodynamic cancer therapy model. J Pharm Pharmacol 2001; 53:155-66. [PMID: 11273011 DOI: 10.1211/0022357011775352] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
pH-sensitive polymeric micelles of randomly and terminally alkylated N-isopropylacrylamide copolymers were prepared and characterized. Aluminium chloride phthalocyanine (AlClPc), a second generation sensitizer for the photodynamic therapy of cancer, was incorporated in the micelles by dialysis. Their photodynamic activities were evaluated in-vitro against EMT-6 mouse mammary tumour cells and in-vivo against EMT-6 tumours implanted intradermally on each hind thigh of Balb/c mice. pH-sensitive polymeric micelles were found to exhibit greater cytotoxicity in-vitro than control Cremophor EL formulations. In the presence of chloroquine, a weak base that raises the internal pH of acidic organelles, in-vitro experiments demonstrated the importance of endosomalllysosomal acidity for the pH-sensitive polymeric micelles to be fully effective. Biodistribution was assessed by fluorescence of tissue extracts after intravenous injection of 2 micromol kg(-1) AlClPc. The results revealed accumulation of AlClPc polymeric micelles in the liver, spleen and lungs, with a lower tumour uptake than AlClPc Cremophor EL formulations. However, polymeric micelles exhibited similar activity in-vivo to the control Cremophor EL formulations, demonstrating the higher potency of AlClPc polymeric micelles when localized in tumour tissue. It was concluded that polymeric micelles represent a good alternative to Cremophor EL preparations for the vectorization of hydrophobic drugs.
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Affiliation(s)
- J Taillefer
- Faculty of Pharmacy, University of Montreal, Qc, Canada
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Ducluzeau R, Le Garrec D, Salomon JC. [Interaction between a sensitive strain and two lysogenic strains of staphylococci implanted in the digestive tract of axenic mice]. Ann Inst Pasteur (Paris) 1968; 114:857-67. [PMID: 5760434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Le Garrec D. [Risk factors during surgical treatment of esophageal atresia]. Anesth Analg (Paris) 1966; 23:359-70. [PMID: 5933544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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