Search

The use of high dose baclofen for alcohol-dependence emerged in France from 2008 based on empirical findings, and is still off-label. However, due to the rapid increase in this prescribing practice, the French health authorities have decided to frame it using an extraordinary regulatory measure named "temporary recommendation for use" (TRU). Baclofen prescribers from CAMTEA, a regional team-based off-label system for supervising baclofen prescribing, which was developed much prior to the TRU, discuss herein the pros and cons of this measure and the applicability of its different aspects in the daily clinical practice., (© 2014 Société Française de Pharmacologie et de Thérapeutique.)

Several clinical and epidemiological studies have demonstrated that a high level of plasma fibrinogen is an independent risk factor for coronary, cerebral and peripheral artery disease. The role of fibrinogen in cardiovascular diseases is mainly due to thrombotic complications in advanced stages of the atherothrombotic disease. However, fibrinogen also plays an active role in the initiation and development of atheromatous plaques. The relations between fibrinogen and ischemic cardiopathies, other vasculopathies and diabetes mellitus are discussed. The controversial effects of statins on fibrinogen are also described.

Cardiac pacemakers' insertions may be associated with different types of complications such as lead's malposition. The authors report the observation of lead's malposition in the left ventricular chamber through the interatrial septum. This malposition is potentially dangerous because of the potent risk factor for stroke and thromboembolism that the patient might run. The diagnosis of this malposition can be done by surface electrocardiogram and thorax X-ray. However, we do insist on the importance of echocardiography and furthermore of transesophageal echocardiography which can lead to a much better choice in the treatment.