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Thérapie

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https://www.readbyqxmd.com/read/28647110/success-of-tardive-electroconvulsive-therapy-sessions-after-loxapine-induced-malignant-syndrome-in-the-context-of-very-poor-metabolisation
#1
Juliette Descoeur, Laurent Philibert, Kevin Chalard, Jérôme Attal, Pierre Petit, Kada Klouche, Mathieu Olivier
We report the success of tardive electroconvulsive therapy in a case of loxapine malignant syndrome with catatonia. Loxapine and its metabolites were measured in biological samples by liquid chromatography coupled to tandem mass spectrometry. Genes were studied by sequencing and quantitative polymerase chain reaction (PCR). Plasmatic drug concentrations showed a supratherapeutic concentration of loxapine with a very low 8-hydroxyloxapine/loxapine ratio (range from 0.32 to 0.66, normal value>2 for 100mg) and a very long elimination half-life of loxapine (half-life>140h, normal value from 1 to 4hours)...
May 29, 2017: Thérapie
https://www.readbyqxmd.com/read/28647109/-meopa-use-practices-in-a-university-hospital-which-conformity
#2
Caroline Victorri-Vigneau, Cécile Paille, Caroline Joyau, Gwenaëlle Veyrac, Claire Cosset, Aline Le Pelletier, Pascale Jolliet, Julien Nizard, Emmanuelle Kuhn
INTRODUCTION: MEOPA (equimolar mixture of oxygen and nitrous oxide) is used for its analgesic and anxiolytic properties in order to obtain conscious sedation of the patient when performing painful care. It is subject to an enhanced pharmacovigilance and addictovigilance monitoring. In this context, it is important to dispose of hospital utilization data. This work aims to assess the compliance of the use of nitrous oxide regarding the recommendations of the summary of product characteristics, in a French university hospital (Nantes) and consider possible improvements...
May 26, 2017: Thérapie
https://www.readbyqxmd.com/read/28647108/-alimemazine-induced-restless-legs-syndrome-about-two-cases
#3
LETTER
Céline Gonzalez, Valérie Gras-Champel, Kamel Masmoudi
No abstract text is available yet for this article.
May 26, 2017: Thérapie
https://www.readbyqxmd.com/read/28647107/-justification-of-off-label-antibiotics-uses-in-hospitalized-children
#4
Christelle Berthod, Behrouz Kassaï, Remy Boussageon, Léopold Adelaide, Matthias Jacquet-Lagrèze, Audrey Lajoinie
Unlicensed and off-label (UL/OL) drugs are commonly used in pediatrics wards, especially the antibiotics. It remains unclear if this strategy is justified by randomized controlled trials of good quality? OBJECTIVE: The aim of this study was to compare the level of evidence of UL/OL antibiotics prescription in hospitalized children. The initial hypothesis was that the UL/OL antibiotics prescriptions had a lower level of evidence than licensed antibiotics. METHOD: This observational study assessed the antibiotics prescription in the children mother and women hospital of Lyon...
May 26, 2017: Thérapie
https://www.readbyqxmd.com/read/28647106/-outpatient-consumption-of-antibiotics-with-a-bacterial-resistance-risk-in-2014-in-france
#5
Marie-Céline Casaurancq, Emilie Patras de Campaigno, Manuela Rueter, Bérangère Baricault, Robert Bourrel, Maryse Lapeyre-Mestre, Agnès Sommet
AIM: This article proposes a description of French regional consumption of antibiotics with a bacterial resistance risk (amoxicillin+clavulanic acid, third-generation cephalosporins [C3G] and fluoroquinolones). METHODS: Antibiotics reimbursements data were obtained by Open Medic website. The antibiotic consumption profile has been established using some indicators of the European Surveillance of Antimicrobial Consumption (ESAC) in daily-defined dose per 1000 inhabitants per day (DID) or in percentage...
May 26, 2017: Thérapie
https://www.readbyqxmd.com/read/28647105/-sarcoidosis-occurring-after-chemotherapy-for-breast-cancer-difficulty-of-drug-causality-assessment
#6
LETTER
Kévin Didier, Isabelle Beguinot, Malak Abou-Taam, Amélie Servettaz, Firouze Bani-Sadr
No abstract text is available yet for this article.
May 26, 2017: Thérapie
https://www.readbyqxmd.com/read/28579364/false-positive-results-in-pharmacoepidemiology-and-pharmacovigilance
#7
Julien Bezin, Pauline Bosco-Levy, Antoine Pariente
False-positive constitute an important issue in scientific research. In the domain of drug evaluation, it affects all phases of drug development and assessment, from the very early preclinical studies to the late post-marketing evaluations. The core concern associated with this false-positive is the lack of replicability of the results. Aside from fraud or misconducts, false-positive is often envisioned from the statistical angle, which considers them as a price to pay for type I error in statistical testing, and its inflation in the context of multiple testing...
May 8, 2017: Thérapie
https://www.readbyqxmd.com/read/28577824/-false-positive-results-or-what-s-the-probability-that-a-significant-p-value-indicates-a-true-effect
#8
Michel Cucherat, Silvy Laporte
The use of statistical test is central in the clinical trial. At the statistical level, obtaining a P<0.05 allows to claim the effectiveness of the new studied treatment. However, given its underlying mathematical logic the concept of "P value" is often misinterpreted. It is often assimilated, mistakenly, to the likelihood that treatment is ineffective. Actually the "P value" gives an indirect information about the plausibility of the existence of treatment effect. With "P<0.05", the probability that the treatment is effective may vary depending on other statistical parameters which are the alpha level of risk, the power of the study and especially the a priori probability of the existence of treatment effect...
May 8, 2017: Thérapie
https://www.readbyqxmd.com/read/28457571/-acute-analgesic-effect-of-paracetamol-in-primary-care-incomplete-evidence
#9
Marion Gougain, Alain Moreau, Rémy Boussageon, Gisèle Pickering, François Gueyffier
This meta-analysis assessed the analgesic effect of a single oral dose of paracetamol versus placebo in adults, in primary care. Parallel randomized studies were searched on MEDLINE(®), CENTRAL(®), and EMBASE(®). We found five studies on sore throat (842 patients) and 12 studies on headache (3433 patients). None related to low back pain. Regardless of the outcome, paracetamol was superior to placebo (number need to treat [NNT]=4-5; standardized mean difference [SMD]=0.51-0.92). Additional clinical trials in other primary care conditions, like low back pain, must be conducted...
April 4, 2017: Thérapie
https://www.readbyqxmd.com/read/28461037/post-marketing-drug-withdrawals-pharmacovigilance-success-regulatory-problems
#10
Jeffrey K Aronson
Modern pharmacovigilance began in the 1960s, since when the subject has grown markedly, interest having particularly increased since 2010. One index of its success is the increasing speed with which serious adverse drug reactions are discovered after marketing of a medicinal product. However, the speed with which products have subsequently been withdrawn as a result of the discovery of serious adverse reactions has not consistently changed. This highlights problems that regulators and manufacturers face when serious reactions are discovered, with difficulties in deciding which of several consequent actions to take: to add specific warnings (cautions) or contraindications to the product label; to issue a Direct Healthcare Professional Communication; to allow informed patients to decide whether they will take the drug; or, in the most serious cases, to withdraw the product or revoke the licence...
March 30, 2017: Thérapie
https://www.readbyqxmd.com/read/28457572/analytical-interference-during-cefepime-therapeutic-drug-monitoring-in-intensive-care-patient-about-a-case-report
#11
Laurie Toullec, Julien Dupouey, Coralie Vigne, Amélie Marsot, Laurent Allanioux, Olivier Blin, Marc Leone, Romain Guilhaumou
β-lactams therapeutic drug monitoring (TDM) appears as an essential tool to ensure the achievement of pharmacokinetic-pharmacodynamic targets and prevent induced toxicity in intensive care unit patients. Indeed, those patients exhibit important pharmacokinetic variabilities that could lead to unpredictable plasma concentrations, potentially associated with poor clinical outcome, development of antibiotic resistance or increased side effects. Here, we report the case of a 48-year-old-patient admitted to intensive care unit and treated by cefepime using TDM...
March 30, 2017: Thérapie
https://www.readbyqxmd.com/read/28457570/-psychoactive-effects-of-legal-high-about-lysergic-acid-amide-lsa
#12
Camille Ponté, Maryse Lapeyre-Mestre
Lysergic acid amide (LSA) is a natural psychoactive substance consumed as a psychedelic drug. In 2016, 4 cases were reported to the Toulouse Addictovigilance Centre, resulting in unintended psychic effects and led to a hospitalisation in 2 cases. Other cases of serious LSA intoxication are published, including a death. It is important to inform about the risks related to LSA consumption, a substance which is freely available and sometimes hidden behind various plant names.
March 30, 2017: Thérapie
https://www.readbyqxmd.com/read/28318610/pharmacogenetics-of-immunosuppressants-state-of-the-art-and-clinical-implementation%C3%A2-%C3%A2-recommendations-from-the-french-national-network-of-pharmacogenetics-rnpgx
#13
Jean-Baptiste Woillard, Laurent Chouchana, Nicolas Picard, Marie-Anne Loriot
Therapeutic drug monitoring is already widely used for immunosuppressive drugs due to their narrow therapeutic index. This article summarizes evidence reported in the literature regarding the pharmacogenetics of (i) immunosuppressive drugs used in transplantation and (ii) azathioprine used in chronic inflammatory bowel disease. The conditions of use of currently available major pharmacogenetic tests are detailed and recommendations are provided based on a scale established by the RNPGx scoring tests as "essential", "advisable" and "potentially useful"...
April 2017: Thérapie
https://www.readbyqxmd.com/read/28242126/type-1-gaucher-disease-cyp2d6-eliglustat
#14
Laurent Becquemont
Type 1 Gaucher disease is a rare genetic disease characterized by enzymatic deficit leading to glucosylceramide overload in body tissues (lysosomal overload disease). Standard treatment is based on substitutive enzyme therapy by intravenous perfusion. A new drug for oral administration, eliglustat, was recently awarded marketing approval in Europe and the USA. Eliglustat acts by reducing the enzyme substrate. Eliglustat is mainly eliminated by a CYP2D6 pathway. CYP2D6 exhibits genetic variability or expression, leading to 20-fold differences in serum levels...
April 2017: Thérapie
https://www.readbyqxmd.com/read/28237406/pharmacogenetics-based-personalized-therapy-levels-of-evidence-and-recommendations-from-the-french-network-of-pharmacogenetics-rnpgx
#15
Nicolas Picard, Jean-Christophe Boyer, Marie-Christine Etienne-Grimaldi, Chantal Barin-Le Guellec, Fabienne Thomas, Marie-Anne Loriot
More than 50 laboratories offer pharmacogenetic testing in France. These tests are restricted to a limited number of indications: prevention of serious adverse drug reactions; choice of most appropriate therapeutic option; dose adjustment for a specific drug. A very small proportion of these tests are mentioned in drug information labeling and the data provided (if any) are generally insufficient to ascertain whether a test is required and if it is useful. This article discusses the rationale for evaluating the performance and clinical usefulness of pharmacogenetics and provides, on behalf of the French national network of pharmacogenetics (RNPGx), three levels of recommendation for testing: essential, advisable, and possibly helpful...
April 2017: Thérapie
https://www.readbyqxmd.com/read/28162244/pharmacogenetics-of-hypersensitivity-drug-reactions
#16
Simone Negrini, Laurent Becquemont
Adverse drug reactions are a significant cause of morbidity and mortality and represent a major burden on the healthcare system. Some of those reactions are immunologically mediated (hypersensitivity reactions) and can be clinically subdivided into two categories: immediate reactions (IgE-related) and delayed reactions (T-cell-mediated). Delayed hypersensitivity reactions include both systemic syndromes and organ-specific toxicities and can be triggered by a wide range of chemically diverse drugs. Recent studies have demonstrated a strong genetic association between human leukocyte antigen alleles and susceptibility to delayed drug hypersensitivity...
April 2017: Thérapie
https://www.readbyqxmd.com/read/28416298/-epicutaneous-patch-testing-in-delayed-drug-hypersensitivity-reactions-induced-by-antiepileptic-drugs
#17
Lobna Ben Mahmoud, Najla Bahloul, Hanen Ghozzi, Brahim Kammoun, Ahmed Hakim, Zouheir Sahnoun, Sami Kammoun, Khaled Zeghal
INTRODUCTION: Antiepileptic drugs are widely used and are associated with numerous side effects including skin eruptions. Epicutaneous tests have been used with variable success in skin drug reactions. The purpose of this study was to evaluate the profitability of epicutaneous tests in delayed hypersensitivity reactions induced by antiepileptic drugs. METHODS: We analyzed all cases of allergic skin reactions to antiepileptic drugs notified in regional pharmacovigilance center of Sfax (Tunisia) between June 1, 2014 and April 30, 2016...
March 25, 2017: Thérapie
https://www.readbyqxmd.com/read/28318613/latent-tuberculosis-infection-screening-prior-to-biological-treatment-in-tunisian-patients
#18
Marwa Slouma, Ines Mahmoud, Olfa Saidane, Selma Bouden, Leila Abdelmoula
OBJECTIVES: The screening of latent tuberculosis infection (LTBI) is necessary to prevent infection in patients with chronic inflammatory disease (CID) undergoing biological treatment. We aimed to assess the efficacy of LTBI screening prior to biological treatment in Tunisia, considered as a high-incidence area of active TB disease. METHODS: We conducted a retrospective study over a period of 8 years [2007-2014] including patients with chronic inflammatory rheumatism receiving biologic agents since at least 6 months...
February 24, 2017: Thérapie
https://www.readbyqxmd.com/read/28343650/-surveillance-system-on-drug-abuse-interest-of-the-french-national-oppidum-program-of-french-addictovigilance-network
#19
Elisabeth Frauger, Liselotte Pochard, Quentin Boucherie, Adeline Giocanti, Cécile Chevallier, Amélie Daveluy, Valérie Gibaja, Anne-Sylvie Caous, Céline Eiden, Nicolas Authier, Reynald Le Boisselier, Marylène Guerlais, Émilie Jouanjus, Marion Lepelley, Véronique Pizzoglio, Stéphanie Pain, Nathalie Richard, Joëlle Micallef
It is important to assess drug abuse liability in 'real life' using different surveillance systems. OPPIDUM ('Observation of illegal drugs and misuse of psychotropic medications') surveillance system anonymously collects information on drug abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. The aim of this article is to demonstrate the utility of OPPIDUM system using 2015 data. OPPIDUM is a cross-sectional survey repeated each year since 1995. In 2015, 5003 patients described the modality of use of 10,159 psychoactive drugs...
February 22, 2017: Thérapie
https://www.readbyqxmd.com/read/28336161/-hemorrhage-treatment-evaluation-of-the-proper-use-of-fibrinogen-concentrate
#20
Jennifer Howlett, Christelle Prudent, Emmanuel De Maistre, Philippe Fagnoni, Aline Lazzarotti
An increase in fibrinogen concentrate prescriptions was noticed in 2015 after several guidelines regarding their use were published. We tried to evaluate if they were used appropriately. To evaluate the conformity of the prescriptions to these guidelines, we searched for each prescription if a dosage of blood fibrinogen was made, if its result was below the limit recommended to prescribe fibrinogen concentrate, and if the posology was in line with the recommendations. Effect and security of the treatment was also evaluated...
February 22, 2017: Thérapie
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