Search

L'évolution des prescriptions en rhumatologie reflète un domaine médical en constante mutation, où les avancées scientifiques et les progrès technologiques redéfinissent les pratiques cliniques. Les médicaments anti-inflammatoires (AINS ou corticoïdes), autrefois largement prescrits pour soulager la douleur et l'inflammation, sont maintenant utilisés avec prudence en raison de leurs effets secondaires. L'arrivée des thérapies ciblées a offert des perspectives d'épargne médicamenteuse, mais a également soulevé des points de vigilance spécifique concernant leur tolérance. Les études pharmaco-épidémiologiques bien conçues peuvent fournir des données précieuses sur l'utilisation des médicaments dans des conditions réelles, éclairant ainsi les décisions de prescription, les politiques de remboursement et les choix thérapeutiques. The trend in rheumatology prescriptions reflects an ever-changing medical field, where scientific advances and technological progress are reshaping clinical practices. Anti-inflammatory drugs (NSAIDs or corticoids), once widely prescribed to relieve pain and inflammation, are now used with caution due to their side effects. The development of targeted therapies has opened up the prospect of drug savings, but has also raised specific points of concern regarding their safety. Well-designed pharmaco-epidemiological studies can provide valuable data on drug use in real-life conditions, informing prescribing decisions, reimbursement policies and treatment alternatives. [ABSTRACT FROM AUTHOR]

Uterine fibroids (leiomyomas and myomas) are the most common benign gynecological condition in patients presenting with abnormal uterine bleeding, pelvic masses causing pressure or pain, infertility and obstetric complications. Almost a third of women with fibroids need treatment due to symptoms. Objectives: In this review we present all currently available treatment modalities for uterine fibroids. Methods: An extensive search for the available data regarding surgical, medical and other treatment options for uterine fibroids was conducted. Review: Nowadays, treatment for fibroids is intended to control symptoms while preserving future fertility. The choice of treatment depends on the patient's age and fertility and the number, size and location of the fibroids. Current management strategies mainly involve surgical interventions (hysterectomy and myomectomy hysteroscopy, laparoscopy or laparotomy). Other surgical and non-surgical minimally invasive techniques include interventions performed under radiologic or ultrasound guidance (uterine artery embolization and occlusion, myolysis, magnetic resonance-guided focused ultrasound surgery, radiofrequency ablation of fibroids and endometrial ablation). Medical treatment options for fibroids are still restricted and available medications (progestogens, combined oral contraceptives andgonadotropin-releasing hormone agonists and antagonists) are generally used for short-term treatment of fibroid-induced bleeding. Recently, it was shown that SPRMs could be administered intermittently long-term with good results on bleeding and fibroid size reduction. Novel medical treatments are still under investigation but with promising results. Conclusions: Treatment of fibroids must be individualized based on the presence and severity of symptoms and the patient's desire for definitive treatment or fertility preservation. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The search for optimal osteoporosis treatments continues, as the medications currently used in clinical therapy carry a risk of rare but acute side effects. New knowledge about etiopathogenetic pathways and osteoporosis biomarkers enabled the exact examination of various oral substances, often previously recognised for their positive impact on bone mass growth. A cross-section of novel reports from this year on the applications of many orally administered substances is presented. Diet, gut microbiota aspect, functional food, diabetes drug – empagliflozin and a variety of substances known from Chinese traditional medicine are now characterized in the context of the possible mechanism of treating or preventing osteoporosis. The progress of bone mass density and quality-regulating pathways recognition led to the finding of multiple orally administered substances with favorable mediation properties. The precise diagnosis of the substances' working mechanisms approves their potential use in new formulations of clinical treatments. Presently only used in diet supplementation, the orally administrated antiosteoporotic substances are potential core ingredients of modernized medications, provided their presumptive adverse effects are ruled out.

La disponibilité des médicaments pour les urgences cardiovasculaires permet une prise en charge adéquate des patients. Cette étude avait pour objectif d’évaluer le profil de consommation des médicaments au service des urgences de l’Institut de Cardiologie d’Abidjan dans le but de les rendre disponibles à la pharmacie dudit institut. Notre étude était rétrospective et descriptive. Elle a permis de catégoriser les médicaments prescrits aux urgences de l’Institut de Cardiologie d’Abidjan d’Août 2022 à Avril 2023. Recueillies à l’aide d’une fiche d’enquête, les données récoltées par le biais des ordonnances comprenaient des informations sur la classification ATC des médicaments, la dénomination commune internationale, la dose journalière et le nombre de prises journalières. Les résultats ont été exprimés sous forme de moyenne et de fréquence relative. A partir des 1205 ordonnances collectées destinées à 1008 patients, nous avons noté que chaque patient recevait en moyenne 1,19 ordonnances par jour contenant en moyenne 3,08 lignes de prescriptions par ordonnances. Sept (7) classes ATC ont été identifiées dont les principales étaient les médicaments du système cardiovasculaire (54%), les médicaments du sang (14%) et les médicaments anti-infectieux à usage systémique (13%). Les usages de ces classes étaient justifiés aux urgences de l’Institut de Cardiologie d’Abidjan. Les doses et prises moyennes journalières étaient conformes aux recommandations du Vidal 2022®. La classe des médicaments du système cardiovasculaires ainsi que d’autres classes ont été identifiées comme essentielles au bon fonctionnement des urgences de l’Institut de Cardiologie d’Abidjan.

Background Children with chronic diseases may require several liquid medications daily. As most of pediatric drugs are acidic in nature, dental erosion becomes a potential issue when medicines with prolonged oral clearance are taken for long term. The enamel of deciduous teeth is less calcified and porous which is more easily dissolved by acids. So, erosion can be a particular problem and easier to occur in primary teeth than in permanent teeth. Objectives Assess the erosive effects of pediatric medicaments on primary teeth enamel, and the remineralizing effect of Proshield varnish and MI varnish on demineralized enamel. Patients and methods This experimental controlled trial conducted on 70 extracted primary teeth divided into seven groups. The control group was exposed to artificial saliva. Three groups exposed to Probric syrup, one of them to assess the demineralization occurred in enamel surface, second one was treated first with Proshield and the third one was treated with MI varnish. The remaining three groups were exposed to Depakine syrup, one of them to assess the demineralization effects of the drug, the second one was treated with Proshield, and the third one was treated with MI varnish. Scanning is done to reveal surface changes occurred to the enamel surface and to assess how much the pediatric medicaments affected the enamel. Energy dispersive radiography analysis was done to accurately measure the percentage of elements by weight especially calcium and phosphate percentage. Results The study showed that both pediatric medicaments have erosive potential that led to surface changes and decrease in mineral content of the enamel. Both Proshield and MI varnishes have remineralizing effects on enamel and had decreased the effects of these medicaments but with different levels. Proshield varnish proved more remineralization efficacy with both medicaments. Conclusions Both Probric and Depakine syrups have erosive potential on primary teeth enamel. Proshield varnish showed better remineralization ability as compared to MI varnish. [ABSTRACT FROM AUTHOR]

Copyright of Biologie Aujourd'hui is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This work complements the preexisting bibliographical reviews in English on the various works concerning Punica granatum. This plant-fruit can always promote the production of improved traditional medicines, whose pharmacological and toxicological properties are well-known, in order to contribute to the improvement of human health. [ABSTRACT FROM AUTHOR]

Introduction: Confirmed hypersensitivity to beta-lactams remains overestimated. The impact of a diagnosis by excess or by default is major. Our work aims to describe the allergy workup approach to suspicion of hypersensitivity to beta-lactams through a series of patients in the Tunisian population. Methods: Cross-sectional study focused on a sample of patients presenting hypersensitivity to beta-lactams collected in the allergology "C" department of Mami Ariana Hospital between January 2007 and June 2022. Results: Ninety-eight patients (37 men, 61 women) with an average age of 37.8 years had a suspected allergy to beta-lactam antibiotics. The most common clinical manifestations included: urticaria (n = 73), angioedema (n = 15), anaphylactic shock (n = 13), dyspnea (n = 34), bronchospasm (n = 9), and digestive signs (n = 47). The route of drug administration was the oral route in 83.3 % of cases. The allergy workup was carried out on average 5.5 months after the last presumed drug reaction. Prick tests at pure recommended concentrations were positive in 17 cases (17.3 %) while IDRs were positive in 14 cases. An allergy to cephalosporins was observed in 6 cases. The drug provocation tests performed in 65 patients with negative skin tests were positive in 10 cases. At the end of the allergy workup, the diagnosis of beta-lactam allergy was confirmed in 41 patients (19.3 %). Conclusion: Allergy to beta-lactams is not uncommon. Beta-lactam skin tests have good diagnostic and predictive value for true beta-lactam allergy. [ABSTRACT FROM AUTHOR]

Successful bacterial inactivation or elimination is essential for successful outcomes in endodontics. This study investigated the efficacy of a calcium hydroxide paste (Ca(OH)2) as a temporary medical dressing for 1 week after chemomechanical root canal treatment (CMRCT). Microbiological samples from 26 patients were collected after endodontic emergency treatment as follows: (1) removal of the provisional filling material; (2) CMRCT; (3) irrigation with sodium hypochlorite I (3%); (4) medicinal insertion of Ca(OH)2; and (5) irrigation with sodium hypochlorite II (3%). A microbiological examination was carried out after the specimens had been taken from the root canals via saline and sterile paper points. CMRCT resulted in a significant reduction in total bacterial load (TBL) in the root canal (p < 0.05). Additional irrigation (3) resulted in a further significant reduction in TBL (p < 0.05). In contrast, Ca(OH)2 medication did not prevent the bacterial load from returning to the previous level immediately after CMRCT, but did not increase above that level either (p < 0.05). However, the increase in TBL was significant (p < 0.05) in comparison with the disinfection groups (I/II). Administration of Ca(OH)2 for 1 week shows that in combination with an additional disinfection procedure, an increase in TBL must be expected, but not above the level of conditions after CMRCT. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of the use of Calcium Hydroxide (Ca(OH)2), Triple Antibiotic Paste (TAP), and Double Antibiotic Paste (DAP) as intra-canal medicaments on the development of antibiotic resistance by evaluating tetracycline genes. Methods: Forty five patients were randomly assigned into 3 groups according to the intracanal medication using a web program (www.randomizer.org), (Ca(OH)2, TAP and DAP). Root canal bacteriological samples were collected before root canal treatment (S1) and after chemo-mechanical procedures (S2). Following root canal shaping procedures, intra-canal medication of the root canals was performed with selected intra-canal medicament. A second appointment was planned for the patients 15 days later. At the second appointment, the medication was removed mechanically and after irrigation of the root canals, the post medication samples (S3) were collected. Bacteriological samples were then investigated for bacterial counts and antibioticresistant genes [Tet Repressor proteins (TetR), Tetracycline resistance gene W (TetW) and Tetracycline resistance gene Q (TetQ)] using polymerase chain reaction (PCR), and the data were statistically analyzed. The Friedman, Kruskall-Wallis and chi-square tests were used. These genes were selected as the difference between TAP and DAP is that TAP contains tetracycline and tetracycline resistance is governed by tet genes. Results: There was no statistically significant difference among the samples (S1, S2, and S3) in terms of the number of root canals positive for antibiotic resistance genes in both the Ca(OH)2 and DAP groups. However, the number of root canals positive for TetR gene increased significantly (6 [40%] to 12 [86%]) following intra-canal medication with TAP. Conclusion: It can be concluded that 15 of days intra-canal medication with TAP causes tetracycline resistance. In contrast, DAP does not cause tetracycline resistance and it has similar antibacterial effectiveness to TAP. The DAP would be the choice of medicament rather than TAP in clinical practice. [ABSTRACT FROM AUTHOR]

Contexte : Le développement de phytomédicaments ou médicaments traditionnels améliorés en Afrique sub-saharienne connait un succès grandissant. En Côte d’Ivoire, diverses unités artisanales de fabrication de phytomédicaments se développent mais restent peu évalués pour leur efficacité, innocuité et qualité. Justificatif : Parmi toutes les pathologies affectant la population subsaharienne, le paludisme occupe une place importante étant la première cause de maladie infectieuse parasitaire, et la 3ème cause de maladies infectieuses. Les produits de santé des tradithérapeutes restent peu évalués pour leur efficacité, innocuité et qualité. Les chercheurs et enseignants chercheurs au sein des universités ont emboîté le pas dans plusieurs pays. En Côte d’Ivoire aucune université n’a franchi le pas de la production à l’échelle d’unité industrielle pilote. Objectif : L’objectif de ce travail visait à sélectionner des plantes pour la mise au point de phytomédicaments antipaludiques de qualité de catégorie 2 OMS. Méthodologie : La sélection des plantes à l’essai a concerné celles ayant fait l’objet de travaux de recherche des Universités en Côte d’Ivoire. Parmi ces derniers, ceux évaluant l’effet sur des extraits aqueux de parties aériennes des plantes. De ces extraits ceux présentant les meilleures inhibitions de croissance du Plasmodium selon les critères de Wilcox, ont été retenues pour la mise au point de phytomédicaments de catégorie 2 OMS. Les essais de pré formulation er formulation galénique à l’échelle de laboratoire ont permis de mettre en œuvre le procédé de fabrication adéquat. Une transposition à l’échelle pilote a été ensuite réalisée pour démontrer la reproductibilité de la fabrication industrielle de la forme galénique mise au point. Résultats : Ces résultats issus des travaux de chercheurs des universités ivoiriennes ont permis de recenser 58 plantes médicinales étudiées pour leur activité antiplasmodiale depuis 1996. Parmi ces plantes 38 ont fait l’objet d’extraits aqueux, décoctés ou infusés. Sept extraits aqueux présentant de CI50

Introduction : L’objectif d’un système logistique ne se limite pas à faire en sorte que les produits arrivent au bon endroit, mais également de garantir que les clients bénéficient de la sécurité des produits. Il est donc question dans cette étude de réaliser une analyse situationnelle du système logistique des approvisionnements en médicament au Cameroun. Matériel et méthodes : La population cible comprenait la DPML, le LANACOME, la CENAME, les Programmes Santé, les Grossistes Distributeurs Privés, les Partenaires Techniques et Financiers, la Fonds Régionaux pour la Promotion de la Santé, les Formations Sanitaires Publiques et Privées. La collecte et l'analyse des données ont été réalisées à l'aide de l'outil d'évaluation du système logistique (LSAT), du Guide pour l'évaluation du système de santé et de ses fonctions de base ainsi que de l’outil SWOT. Résultats : 160 produits pharmaceutiques repartis entre les sept programmes de santé ont été identifié. La composante SIGL est celle qui implique le plus de partenaires techniques et financiers (PTF). Le CNLS, le PEV et le PNLP sont les programmes de santé les plus soutenus avec 4 PTF. La région Centre avec 9 PTF est la plus soutenue dans les activités de la chaîne logistique. 37,5% des programmes de santé et 60% des formations sanitaires disposent de responsables à temps plein pour couvrir toutes les activités logistiques. 75 % des programmes de santé ont un SIGL bien défini, informatisé avec un mécanisme de rétro information. 40,9% des structures utilisent la Liste Nationale des Médicaments Essentiels et des protocoles de soins pour la sélection. La mauvaise qualité de service dans les établissements de santé ; les prix élevés des médicaments et l'existence du circuit parallèle représentent chacun 22,22% des obstacles à l'accès aux médicaments. Discussion : Les résultats obtenus peuvent être justifiés par l’importance majeur et primordiale accordée au cœur du système logistique que sont les données (le type de données et la qualité des données). L’appui des PTF apporté au CNLS, PEV et PNLP peut s’expliquer par les différentes missions et objectifs de chaque PTF. Il peut aussi être dû aux données épidémiologiques des maladies. La région du centre est la plus soutenue probablement du fait qu’elle regroupe la majeure partie des structures stratégiques impliquées dans la réflexion, le développement et la mise en place des politiques. Les résultats de l’analyse FFOM des indicateurs par composante corroborent avec ceux cités dans le plan stratégique pour le renforcement de la chaîne d’approvisionnement public des produits de santé au Cameroun 2022- 2026. Conclusion : Au terme de notre étude visant à dresser un état des lieux de la gestion logistique des approvisionnements en médicaments, nous retenons que chaque composante du système logistique possède des forces, mais aussi des faiblesses et des menaces qui fragilisent le système. Cependant, il existe plusieurs opportunités de renforcement ou d’amélioration.

Introduction : De nombreux médicaments sur le marché sont contrefaits et les anti-inflammatoires non stéroïdiens n’échappent pas à la règle. Ce travail avait pour objectif de contrôler la qualité des comprimés de diclofénac de sodium 50 mg commercialisés dans la ville de Yaoundé dans le circuit licite et illicite. Matériel et méthodes : Les échantillons ont été collectés par une méthode aléatoire simple dans le circuit licite et illicite. Les contrôles effectués comprenaient : le contrôle de l’emballage du médicament, le contrôle visuel, l’uniformité de masse, la friabilité, la désagrégation, l’identification et le dosage du principe actif des comprimés. Résultats : Un total de 24 échantillons de diclofénac de sodium a été collectés dont 12 prélevés du circuit licite, tous constitués des comprimés gastro-résistants, et 12 prélevés du circuit illicite 2 lots constitués de comprimés gastro-résistants, 5 lots de comprimés pelliculés et 5 lots de comprimés nus. Sur 24 échantillons analysés, 10 échantillons étaient conformes et provenaient tous du circuit licite. Tous les échantillons analysés étaient conformes à 100% en ce qui concerne le contrôle visuel, le contrôle de l’uniformité de masse et le contrôle de la friabilité. La totalité des échantillons analysés a révélé la présence du diclofénac de sodium. Les non-conformités observées sur l’ensemble des échantillons étaient de quatre types : le défaut de l’emballage des médicaments (2 échantillons sur 12 soit 16,67% dans le circuit licite versus 12 échantillons sur 12 soit 100% dans le circuit illicite), le défaut de la désagrégation des comprimés (1 échantillon sur 12 soit 8,33% dans le circuit licite versus 2 échantillons sur 12 soit 16,67% dans le circuit illicite), le sous dosage (0% dans le circuit licite versus 3 échantillons soit 25% dans le circuit illicite), le surdosage en principe actif (0% dans le circuit licite versus 1 échantillon soit 8,33% dans le circuit illicite). Conclusion : La non-conformité touche à la fois le circuit licite et illicite. La plupart des échantillons du secteur illicite sont non conformes. Toutes ces non-conformités exposent la population aux échecs thérapeutiques et la survenue de nouvelles pathologies.

Résumé: Les colites microscopiques (CM), colites collagène (CC) et lymphocytaire (CL), à l'origine de diarrhées sécrétoires chroniques, sont très probablement secondaires à une réponse immunitaire inappropriée vis-à-vis d'un antigène intra-luminal survenant chez un sujet génétiquement prédisposé. L'origine de cette dysfonction immunitaire est inconnue mais différents facteurs déclenchants ou favorisants tels que des médicaments ont été largement évoqués. Les trois principales classes thérapeutiques associées aux CM dans de nombreuses études de cohortes ou cas-contrôles sont les inhibiteurs de la pompe à protons, les anti-inflammatoires non stéroïdiens et les inhibiteurs sélectifs de la recapture de la sérotonine. D'autres médicaments, incriminés dans des cas cliniques rapportant directement un lien de cause à effet entre le médicament et la CM, ont été analysés à l'aide de l'algorithme développé par Beaugerie et al. et l'imputabilité de chaque médicament a été évaluée. La prise en charge initiale d'une CM impose d'éliminer une maladie cœliaque associée et une cause médicamenteuse. Tout médicament commencé dans les quatre mois précédant l'apparition de la diarrhée doit être suspecté, son arrêt entraînant une amélioration clinique en quelques jours et la disparition des lésions histologiques en quelques semaines. Microscopic colitis (MC), collagenous (CC) and lymphocytic colitis (LC), the cause of chronic secretory diarrhea, is very likely secondary to an inappropriate immune response to an intraluminal antigen occurring in a genetically predisposed subject. The origin of this immune dysfunction is currently unknown but various triggering or promoting factors such as drugs have been widely discussed. The 3 main therapeutic classes associated with the occurrence of MC in many cohort or case-control studies are proton pump inhibitors, nonsteroidal anti-inflammatory drugs and selective serotonin reuptake inhibitors. Other drugs, implicated in clinical cases directly reporting a causal link between the drug and CM, were analyzed using the algorithm developed by Beaugerie et al. and the imputability of each drug was evaluated. The initial management of a CM imposes to eliminate an associated celiac disease and a drug cause. Any drug started in the 4 months preceding the onset of diarrhea should be suspected, its withdrawal leading to clinical improvement in a few days and the disappearance of histological lesions in a few weeks. [ABSTRACT FROM AUTHOR]

Although drug-induced liver injury is a rare clinical event, it causes significant morbidity and mortality, making it the leading cause of acute liver failure. The predominant clinical presentation is acute hepatitis and/or cholestasis, although almost any clinical pathological pattern of acute or chronic liver disease can occur. The pathogenesis of drug-induced liver disease usually involves the drug or metabolites that directly affect cellular biochemistry or elicit an immune response. Susceptibility to drug-induced hepatotoxicity is also influenced by genetic and environmental risk factors. Unpredictable, low-frequency and idiosyncratic reactions often occur in the context of high levels of mild asymptomatic liver damage and, although difficult to predict, can be detected by monitoring serum alanine aminotransferase levels. The development of various drug-injury networks has played a key role in expanding our knowledge of liver injury associated with drugs, herbs and dietary supplements. [ABSTRACT FROM AUTHOR]

The aim was to compare hydroxyl ion diffusion through dentine following placement of calcium hydroxide and Ledermix paste. Thirty‐six teeth were divided into one control (n = 6) and three experimental (n = 10) groups – (i) Pulpdent paste; (ii) Pulpdent/Ledermix pastes; (iii) Ledermix paste and (iv) Saline. pH was measured in inner and outer dentine cavities over 12 months. Inner dentine time to maximum pH (Tmax) was 1 week for Pulpdent and 2 weeks for Pulpdent/Ledermix. Pulpdent's outer dentine Tmax was 4 weeks and Pulpdent/Ledermix was 10 weeks. After day 1, Pulpdent pH was higher and this continued for 12 months. Pulpdent's outer dentine pH was higher than Ledermix and controls, but not significantly different from Pulpdent/Ledermix. Pulpdent/Ledermix had significantly higher pH than controls and Ledermix from day 5 until 10 months when Pulpdent/Ledermix outer dentine pH decreased and became similar. In all groups, pH reduced after 3 months. [ABSTRACT FROM AUTHOR]

Uterine fibroids (leiomyomas and myomas) are the most common benign gynecological condition in patients presenting with abnormal uterine bleeding, pelvic masses causing pressure or pain, infertility and obstetric complications. Almost a third of women with fibroids need treatment due to symptoms. Objectives: In this review we present all currently available treatment modalities for uterine fibroids. Methods: An extensive search for the available data regarding surgical, medical and other treatment options for uterine fibroids was conducted. Review: Nowadays, treatment for fibroids is intended to control symptoms while preserving future fertility. The choice of treatment depends on the patient’s age and fertility and the number, size and location of the fibroids. Current management strategies mainly involve surgical interventions (hysterectomy and myomectomy hysteroscopy, laparoscopy or laparotomy). Other surgical and non-surgical minimally invasive techniques include interventions performed under radiologic or ultrasound guidance (uterine artery embolization and occlusion, myolysis, magnetic resonance-guided focused ultrasound surgery, radiofrequency ablation of fibroids and endometrial ablation). Medical treatment options for fibroids are still restricted and available medications (progestogens, combined oral contraceptives andgonadotropin-releasing hormone agonists and antagonists) are generally used for short-term treatment of fibroid-induced bleeding. Recently, it was shown that SPRMs could be administered intermittently long-term with good results on bleeding and fibroid size reduction. Novel medical treatments are still under investigation but with promising results. Conclusions: Treatment of fibroids must be individualized based on the presence and severity of symptoms and the patient’s desire for definitive treatment or fertility preservation.

Résumé Introduction : La mise sur le marché des médicaments homéopathiques, dont l’efficacité est contestée, mérite réflexion dans les pays peinant à couvrir les besoins de santé essentiels. Leur présence dans un segment du secteur pharmaceutique au Sénégal est évaluée dans cette étude. :Matériels et méthodes : Une fiche d’enquête a été renseignée lors d’entretiens avec les personnels de pharmacies de quatre localités de la banlieue dakaroise. Les données collectées ont fait l’objet d’4une analyse descriptive et comparative. Résultats et discussion : Sur 100 établissements sollicités, ont collaboré 20 à Guédiawaye (GDW), 15 à Hann Bel Air (HBA), 17 aux Parcelles assainies (PA) et 20 à Pikine (PKN). Si aucune activité de préparation n’a été notée, des spécialités homéopathiques, provenant pour 81,42% de fournisseurs locaux, étaient disponibles dans 70% des officines de à GDW ; 66,67% de HBA ; 35,29% des PA et 40% de PKN. Tenant compte de la forme, du dosage et du conditionnement, 46 formes solides, 32 formes liquides et 12 formes semi-solides ont été recensée ; avec par ordre de fréquence décroissante les comprimés (73,9%), les sirops (65,6%), les crèmes (58,3%), les pommades (41,7%) et les granules (23,9%). Ces produits représentaient une part infime ou, au mieux, moins de 1 % du chiffre d’affaires pour 92,1% des officines, entre 1 et 5 % pour les autres. :Conclusion : Bien que faible en volume et en valeur, la présence des médicaments homéopathiques est observée dans la majorité des établissements ayant collaboré. La cohérence de leur mise sur le marché est contestable en l’absence de praticiens spécialisés et de contrôles appropriés Mots clés : médicaments homéopathiques, présence, officines, Dakar

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Health History is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The emergence of modern chemical weapons and chemical warfare is traditionally associated with World War I, but the use of poisons in the military has its roots deep in the past. The sources of these poisons have always been natural agents that also served as medicines. This relationship between poison and medicine, and nowadays between chemical warfare and medicine, or between 'military chemistry' and pharmacy, appears to be very important for understanding not only the history but also the possible future of both phenomena. This article looks at some historical examples of the use of drugs as chemical weapons and, conversely, the use of chemical weapons as medicines. It seeks to find answers to some questions that are particularly relevant to the implementation of the Chemical Weapons Convention, which aims to achieve a world without chemical warfare. [ABSTRACT FROM AUTHOR]

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Successful bacterial inactivation or elimination is essential for successful outcomes in endodontics. This study investigated the efficacy of a calcium hydroxide paste (Ca(OH)2) as a temporary medical dressing for 1 week after chemomechanical root canal treatment (CMRCT). Microbiological samples from 26 patients were collected after endodontic emergency treatment as follows: (1) removal of the provisional filling material; (2) CMRCT; (3) irrigation with sodium hypochlorite I (3%); (4) medicinal insertion of Ca(OH)2; and (5) irrigation with sodium hypochlorite II (3%). A microbiological examination was carried out after the specimens had been taken from the root canals via saline and sterile paper points. CMRCT resulted in a significant reduction in total bacterial load (TBL) in the root canal (p < 0.05). Additional irrigation (3) resulted in a further significant reduction in TBL (p < 0.05). In contrast, Ca(OH)2 medication did not prevent the bacterial load from returning to the previous level immediately after CMRCT, but did not increase above that level either (p < 0.05). However, the increase in TBL was significant (p < 0.05) in comparison with the disinfection groups (I/II). Administration of Ca(OH)2 for 1 week shows that in combination with an additional disinfection procedure, an increase in TBL must be expected, but not above the level of conditions after CMRCT.

Introduction: In Senegal, the main causes of death are the pneumonia, the diarrhea and the malaria. The malnutrition is an underlying factor in more than a third of the deaths, because it returns the more vulnerable children to the serious illnesses. The general objective of this research is to study the availability and the price of medicine in the therapeutic care of the children of less than 5 years old in the region of Dakar in Senegal. Methodology: Our study is of transverse, descriptive concerned the public sanitary, the wholesalers, the private pharmacies, The population of study concerns the old children at least of 5ans. The methods used were the interviews by means of questionnaire.. Results: The group of antibiotics, acid anti, antidotes, vitamins, diuretics, antiemetic's, and psychotropic were not available. As regards generic medicines, relatively low availability of 30,4 %, 23,8 % and 16,7 % is respectively observed in the public, private and denominational sectors. The availability of generic medicines in Dakar was from 81 % in the public sector and from 113 % in the private sector. Conclusion: The findings make it imperative for all other relevant medicine drugs in order to reduce the mortality rate. [ABSTRACT FROM AUTHOR]

Déterminer les aspects épidémiologiques, phénotypiques, étiologiques et évolutifs des NET au service de Dermatologie de l'HALD. étude transversale à recrutement rétrospectif sur 15 ans (2005–2019) incluant tous les dossiers de patients hospitalisés au service de Dermatologie de l'HALD pour NET. Les données étaient collectées par le logiciel Sphinx et analysées par SPSS20.0. L'appréciation des associations a été effectuée à l'aide du test de X2. Tout p ≤ 0,05 était statistiquement significatif. Nous avons colligé 142 cas de NET soit 44,4 % des toxidermies. L'âge moyen était de 32,84. Il existait une corrélation significative entre la survenue de nécrolyse épidermique et l'âge (p = 0,0001). Il s'agissait de 80 cas de syndromes de Lyell (SL), 41 cas de syndromes de Steven Johnson (SSJ), 21 cas de syndromes de chevauchement (SC). Les médicaments inducteurs étaient non identifiés chez 46 cas (32,4 %). Les NET étaient induits par les anticonvulsivants dans 19 %, les antibiotiques (Cotrimoxazole) dans 10,6 %, les antalgiques (Paracétamol) dans 10,6 %, les antigoutteux (Allopurinol) dans 7 %, les antipaludéens (Sulfadoxine-pyriméthamine) dans 4,9 %, les antiinflammatoires (Ibuprofène) dans 4,2 %, les ARV (Névirapine) dans 2,1 %. La phytothérapie orale a aussi été incriminée à 7,7 %. Le décès noté dans 17,6 % des cas était souvent secondaire à un choc septique. Le décès était corrélé à l'âge (p = 0,002), au type de toxidermie (p = 0,006) et le délai d'hospitalisation (p = 0,05). Les NET sont dominées par le syndrome de Lyell (56,3 %). Les anticonvulsivants sont les principaux médicaments pourvoyeurs. To determine the epidemiological, phenotypic, etiological and evolutionary aspects of NET in the Dermatology department of the HALD. cross-sectional study with retrospective recruitment over 15 years (2005–2019) including all the files of patients hospitalized in the Dermatology department of HALD for NET. Data were collected by Sphinx software and analyzed by SPSS20.0. The associations were assessed using the X2 test. Any P ≤ 0.05 was statistically significant. We collected 142 cases of NET (44.4% of cutaneous drug reaction). The mean age was 32.84. There was a significant correlation between the occurrence and age (P = 0.0001). These were 80 cases of Lyell syndrome (SL), 41 cases of Steven Johnson syndrome (SJS), and 21 cases of overlap syndrome (SC). The inducing drugs were not identified in 46 cases (32.4%). NETs were induced by anticonvulsants in 19%, antibiotics (Cotrimoxazole) in 10.6%, analgesics (Paracetamol) in 10.6%, anti-gout drugs (Allopurinol) in 7%, antimalarial (Sulfadoxine-pyrimethamine) in 4.9%, anti-inflammatory drugs (Ibuprofen) in 4.2%, ARVs (Nevirapine) in 2.1%. Oral herbal medicine was also incriminated at 7.7%. Death noted in 17.6% of cases was often secondary to septic shock. Death was correlated with age (P = 0.002), type of drug eruption (P = 0.006) and time to hospitalization (P = 0.05). NETs are dominated by Lyell syndrome (56.3%). anticonvulsants are the main induced drugs. [ABSTRACT FROM AUTHOR]

Introduction: many health systems in developing countries still face inappropriate medication use. The purpose of this study was to evaluate drug prescribing and dispensing practices in Mali. Methods: we conducted a cross-sectional study among patients with a prescription in public and private sector drug outlets in Bamako, Kayes, Koulikoro, Sikasso, Ségou and Mopti from August to September 2021. Results: a total of 320 prescriptions were collected in our study. The majority of prescribers were general practitioners in the public and private sectors. However, dispensing pharmacists were in the minority in the public sector (3,75%) versus the private sector (40%). The average number of drugs (3,4) and prescriptions for antibiotics (58%), injectables (60,3), generic international nonproprietary names (Inn) (81%) were higher in the public sector compared to the private sector with 3, 43%, 24% and 26,1% respectively. Despite the high average cost of prescriptions in the public (4300 FCFA or about 6 euros) and private (11500 FCFA or about 17 euros) sectors, the majority of them were totally purchased (69,7% and 78,7% respectively). Only 25% of prescribers interviewed in public hospitals and community health centres had received training on the rational use of drugs. Conclusion: the prescribing indicators were, on the whole, above the recommended standards. Strengthening the capacities of actors would be appropriate to address this situation. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the protective activity of brown seaweed, the ethanolic and water extracts of Sargassum binderi (S. binderi) were examined. Anticancer drug, cisplatin is normally used for the treatment of solid tumors that cause acute kidney damage after assemblage in the renal tubules., Material and Methods: It was an acute nephrotoxicity study, animals were divided into several groups randomly, cisplatin (7mg/kg i.p.) and normal saline were used as positive and negative control respectively. The S. bindari ethanolic and water extract were given orally in a dose of 200mg/kg for 5days. Various biomarkers were assessed to observe the nephroprotective potential, while antioxidant activities were investigated using reduced glutathione, catalase and malondialdehyde as oxidative stress. GCMS was performed to validate the presence of important therapeutic moieties., Results: The current result justified that pretreatment with S. binderi inhibited the elevation of antioxidant parameters and also showed protection against lipid peroxidation, induced by cisplatin challenge. The overall impact was the nephroprotection, which has been revealed from the results. GCMS evaluation of hexanes fraction revealed the presence of therapeutically important compounds including heptasiloxane, 3,7,11,15-tetramethyl-2-hexadecen-1-ol, hexadecamethyl, cyclooctasiloxane, and hexadecamethyl. These compounds have been reported for their antioxidant, antibacterial, anticancer, and antifungal activities., Conclusion: S. binderi showed reno-protective effect by checking their well-known biochemical parameters probably due to the antioxidant activity as confirmed by the presence of compounds., (Copyright © 2024 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

Objectives: This study aims to investigate the impact of photobiomodulation (PBM) and/or azithromycin (AZM) therapy in combination with full-mouth subgingival instrumentation (FSI) on receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) levels and RANKL/OPG ratios in gingival crevicular fluid (GCF) on patients with stage III-IV grade C periodontitis., Materials and Methods: The study was conducted on 77 stage III-IV grade C periodontitis patients and 20 periodontally healthy controls. Patients with stage III-IV grade C periodontitis were categorized into four treatment groups: 1) only FSI (FSI) group; 2) FSI&#43;AZM (AZM) group; 3)FSI&#43;PBM (PBM) group and 4) FSI&#43;PBM&#43;AZM (AZM&#43;PBM) group. Clinical periodontalparameters and RANKL and OPG levels and RANKL/OPG ratios in GCF were measured at thebaseline and month 3rd of the therapy., Results: Compared with the periodontally healthy controls,all the baseline clinical parameters were higher in the Stage III-IV grade C periodontitis groups (P< 0.05); however, there were no statistically significant differences between the Stage III-IV gradeC periodontitis groups (P>0.05). In month 3rd, the lowest values in all clinical parameters weregenerally observed in the antibiotics groups whereas the highest values were observed in the FSIgroup. Furthermore, the highest RANKL and OPG values in antibiotic groups and the highestRANKL/OPG ratio in PBM group were observed in the third months. RANKL/OPG ratios did notchange in the FSI and antibiotics groups after the treatment, but it increased significantly in thePBM group., Conclusion: While PBM treatment combined with FSI increases the RANKL levels,AZM increases OPG levels. Also, PBM&#43;AZM treatment shows additional clinical andimmunological beneficial efficacy.

The spectrum of treatment options for patients with heart failure with reduced ejection fraction (HFrEF) has substantially expanded over the last years. The 2021 guidelines of the European Society of Cardiology propose a new treatment algorithm for patients with HFrEF and define the role of the currently available drugs, interventions and devices in this context. The new standard is a basic therapy consisting of four drugs with different mechanisms of action for all patients with HFrEF: an angiotensin-converting enzyme inhibitor, a betablocker, a mineralocorticoid antagonist, and a sodium glucose co-transporter-2 inhibitor. Additional drugs and/or interventions/devices are indicated depending on the response to the four-drug basic therapy (which has to be up-titrated to the maximally tolerated doses) and the clinical phenotype. In the present article, we discuss the available drugs and devices, their role in the proposed HFrEF treatment algorithm and clinically relevant practical aspects. [ABSTRACT FROM AUTHOR]

Cet article a pour but de rappeler les circonstances de la création du réseau d'Allergo-Vigilance® (RAV), son cadre juridique et ses missions: tenue d'un registre des cas d'anaphylaxie sévères quelqu'en soient les étiologies (alimentaires, médicamenteuses, hyménoptères ou autres), participation à des études multicentriques, formation médicale continue, publications, rôle de veille sanitaire (allergènes émergents..), outil épidémiologique.. De plus, les modalités de recueil et d'analyse des déclarations, l'accès au site informatique (https://www.allergyvigilance.org), les principaux travaux du RAV, les liens avec le réseau européen NORA sont rappelés ainsi que les différents projets à venir. The purpose of this article is to recall the circumstances of the creation of the Allergo-Vigilance® network (RAV), its legal framework and its missions: keeping a register of severe anaphylaxis cases whatever the etiology (food, drugs, hymenoptera or others), participation in multicentric studies, continuing medical education, publications, health watch role (emerging allergens..), epidemiological tool.. In addition, the methods of collecting and analyzing declarations, access to the computer site (https://www.allergyvigilance.org), the main work of the RAV, the links with the European network NORA are recalled as well as the various projects to come. [ABSTRACT FROM AUTHOR]

The endodontic management of necrotic immature permanent teeth is often challenging for the clinician. Regenerative endodontic treatment has emerged as an important alternative to the traditional apexification treatment in such cases. In regenerative endodontics, elimination of microbes from the root canal is important for the survival, proliferation, and differentiation of stem cells. Translational studies suggest that irrigants and medicaments used for root canal disinfection may adversely affect stem cells and ultimately, the regenerative outcome. Conventionally, irrigants and medicaments have been chosen for their maximum antimicrobial effect without considering their effects on stem cells and the dentinal microenvironment. In this review, advances in disinfection for regenerative endodontics are discussed.

L'observation des urines à des fins diagnostiques, dont l'origine remonte à l'Égypte ancienne, est une pratique médicale toujours pertinente en médecine moderne. Plusieurs maladies portent le nom de la couleur observée et témoignent de la valeur sémiologique des urines : la maladie des langes bleus, le syndrome de la poche à urines violettes, la maladie des urines noires ou encore les porphyries. Une coloration anormale des urines peut poser quelques difficultés diagnostiques pour le clinicien : elle peut révéler une maladie néoplasique (cancer urologique ; mélanome), une lyse cellulaire (rhabdomyolyse ; hémolyse), une infection (filariose lymphatique ; paludisme), un déficit enzymatique (porphyries ; alcaptonurie) ou être simplement le témoin d'une prise médicamenteuse ou alimentaire particulière. Nous abordons dans cet article la démarche diagnostique, les mécanismes physiopathologiques et les principales étiologies à évoquer devant une coloration anormale des urines. Looking at the urine for diagnostic purposes, once performed by ancient Egyptians, can still provide some valuable clues in modern medicine. Several diseases have been named after their associated urine color and this underlines the clinical value of visual urine inspection: blue diaper disease, purple urine bag syndrome, black urine disease or porphyria. Abnormal urine color could be challenging for the clinician: it may reveal neoplastic disease (urologic cancer; melanoma), cell lysis (rhabdomyolysis; hemolysis), infection (lymphatic filariasis; malaria), enzyme deficiency (porphyria; alkaptonuria), medication or food intake. In this article, we present the diagnostic approach, the mechanisms involved and the main causes of abnormal urine color. [ABSTRACT FROM AUTHOR]

Copyright of Lecturas de Economia is the property of Universidad de Antioquia, Facultad de Ciencias Economicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Traditional, topically used oral medicaments are of great importance in the treatment of both oral and systemic diseases. Therefore, the aim of this study was to review the indications of various drug delivery forms and active ingredients of currently used medications in complementary medicine, as well as the results of recent research to find any possible conformity between their traditional and recent pharmaceutical properties. Methods: In this review article, different resources including electronica databases, hand searching, the screening of reference lists and contacting experts were extensively performed, followed by categorizing the extracted data. Results: Based on the results, 6 drug forms were found in gaseous, liquid, and solid states with more than 70 formulations. Liquid and gaseous forms were mainly used to manage systemic conditions and solid forms were mainly applied for local treatments. In addition, the investigation of about 50 herbal components showed that the traditional therapeutic effects of the vast majority of the ingredients were in line with those of the recent studies. However, no clinical studies were found regarding the traditionally mentioned systemic effects after the topical use of this medicament in the form of gargles or mouthrinse. Conclusions: In general, the side effects of oral and injectable drugs, as well as the specific advantages of oral mucosa in achieving the topical and systemic effects and the variety of the plant components of Iranian traditional oral medicament might have high potentials for finding new drugs and improving treatment strategies of some systemic diseases such as central nervous system diseases and depression.

The emergence of modern chemical weapons and chemical warfare is traditionally associated with World War I, but the use of poisons in the military has its roots deep in the past. The sources of these poisons have always been natural agents that also served as medicines. This relationship between poison and medicine, and nowadays between chemical warfare and medicine, or between ‘military chemistry’ and pharmacy, appears to be very important for understanding not only the history but also the possible future of both phenomena. This article looks at some historical examples of the use of drugs as chemical weapons and, conversely, the use of chemical weapons as medicines. It seeks to find answers to some questions that are particularly relevant to the implementation of the Chemical Weapons Convention, which aims to achieve a world without chemical warfare.

Introduction: Traditional medicine has become an important component in the care system of African populations. Many products derived from it are increasingly used in the therapeutic arsenal. This work is an inventory of the production of these drugs in two countries of West Africa, Burkina Faso and Benin. Methods: A cross-sectional descriptive study that listed the drug manufacturing units producing medicines derived from the traditional pharmacopoeia (MDTP) identified by the health ministries in the two countries was carried out. Results: Thirty-three production facilities, including 10 in Burkina Faso and 23 in Benin, were surveyed. Seven units surveyed in Burkina Faso and 16 in Benin were illegally installed. Only 16 of the 33 units obtain their raw materials from botanical gardens. The rest obtain theirs through picking which is not favorable to the perpetuation of the plant resource. In addition, among the 1041 MDTPs manufactured by the units surveyed, only 1.44% are registered. Finally, shortcomings in applying good practices for harvesting raw materials and manufacturing finished products were noticed. Conclusion: Management and capacity building efforts of MDTPs production facilities by political authorities are still needed to optimize the contribution of traditional medicine to the health care of African populations. [ABSTRACT FROM AUTHOR]

Au Burkina Faso, le taux de mortalité infanto-juvénile demeure élevé. La barrière financière est souvent indexée comme étant la cause de non-utilisation des services de santé accentuant le risque de décès dans cette frange de la population. Des politiques d’allègement des charges financières sont formulées et mises en oeuvre. C’est dans cette optique que la politique d’exemption de paiement direct des soins au profit des enfants de moins de 5 ans et des femmes enceintes est mise en oeuvre depuis avril 2016. Elle vise la réduction de la mortalité infanto-juvénile. L’application de cette politique de gratuité a entraîné la surconsommation des services de santé (augmentation du nombre de contacts par an et par enfant de 77 % entre 2015 et 2018). La disponibilité des médicaments, condition incontournable pour l’atteinte de l’objectif de la gratuité a conduit à la réalisation de cette recherche dans trois structures de soins de premier niveau de la direction régionale de la santé du Centre (Ouagadougou). Nous avons opté pour une démarche mixte quantitative-qualitative. Une enquête par distanciation sociale a permis de collecter les données au cours de 137 observations directes. De plus, 33 entretiens individuels et un focus group ont été également réalisés respectivement auprès des usagers et des soignants. La collecte des données a duré six mois. Les principaux résultats montrent une disponibilité insuffisante en médicaments. Le ministère de la Santé n’a pas tiré les leçons y relatives issues de la mise en oeuvre de la subvention des accouchements. Il n’a pas prévu de mesures d’atténuation de ces ruptures en médicaments malgré son importance pour le succès de la gratuité mainte fois réaffirmée dans les documents officiels. Les bénéficiaires de la gratuité ont alors recours à d’autres stratégies de financement des coûts supplémentaires pour compenser le manque de médicaments. Lesquelles stratégies induisent des conséquences sociales et économiques désastreuses pour les ménages. [ABSTRACT FROM AUTHOR]

Résumé: La durée et l'intensité des crises migraineuses varient d'un patient à l'autre, ainsi que le handicap personnel, familial et social qui en résulte. Cette hétérogénéité explique sans doute en partie les grandes variations pour le recours aux soins. Aucune des molécules dont l'efficacité a été démontrée n'a fait la preuve de sa supériorité par rapport aux autres. Le choix repose donc sur les comorbidités, les effets indésirables potentiels, les interactions et les autres produits reçus par le patient. L'éducation du patient et la recherche des facteurs déclenchants sont à la base du traitement préventif des crises. Quel intérêt des nouveaux antimigraineux ? Qu'en est-il des traitements de fond non pharmacologiques ? Duration and intensity of migraine attacks vary from patient to patient, as does the resulting personal, family and social handicap. This heterogeneity undoubtedly partly explains the large variations in the use of care. None of the molecules whose efficacy has been demonstrated has proved its superiority over the others. The choice is therefore based on comorbidities, potential adverse effects, interactions and other products received by the patient. Patient education and research into triggering factors are the basis of the preventive treatment of seizures. What interest of the new anti-migraine drugs? What about non-pharmacological treatments? [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Comme il existe une jurisprudence condamnant le défaut d'information au patient conducteur, nous proposons aux patients cliniquement stabilisés des séances d'éducation thérapeutique. Un simulateur de conduite d'auto-école est utilisé comme outil. Cependant, il n'existe pas de moyen pour différencier l'influence du traitement médicamenteux de l'influence de la pathologie sur la conduite et aider l'équipe médicale à proposer un avis. Un score appelé score des pictogrammes, qui est le total des niveaux de risque conduite de tous les médicaments prescrit, est calculé. Le score pictogramme est ensuite comparé pour chaque patient au score de conduite obtenu sur le simulateur. Quinze patients ambulatoires stabilisés (dépressifs, bipolaires ou schizophrènes), (8H, 7F, de 50,67 ± 6,53 ans), possédant un permis de conduire B depuis 29,53 ± 8,16 ans, sans pathologie somatique et ne recevant que des psychotropes à des posologies thérapeutiques, ont donné leur consentement. Le score de conduite obtenu sur le simulateur est comparé à la moyenne d'un groupe de 15 sujets sains témoins (8H et 7F de 32 ± 8,67 ans et 13,07 ± 7,94 ans de permis) ne prenant aucun médicament à l'exception d'une contraception hormonale pour les femmes. La formule du score du total des pictogrammes est la somme des niveaux réglementaires des « pictogrammes conduite » pondérés de tous les médicaments psychotropes présents sur l'ordonnance de chaque patient. La moyenne des scores sur simulateur de conduite du groupe des patients est significativement inférieure à celles du groupe de sujets sains témoins avec respectivement 64,67 ± 10,40 (32 à 82) et 79,67 ± 6,84 (62 à 92) (p = 0,0018). Si 20 % des patients de notre échantillon ont échoué (score ≤ 50/100), 74 % ont des capacités de conduite sur simulateur comparables aux témoins. Sur les 12 derniers mois précédant l'étude, les patients n'ont comme antécédents que des accidents de la voie publique alors que les témoins n'ont que des contraventions pour excès de vitesse. Les médecins psychiatres, dont un médecin certifié pour le contrôle médical du permis de conduire, estiment que la séance pousse le patient à progresser « à contresens », il surmonte ses propres « interdits » intériorisés par ses appréhensions en situation de conduite. Le score des pictogrammes de l'ordonnance peut permettre de mesurer le niveau de risque de la polymédication. Il est analysé en tenant compte du type de molécule, de la posologie, du délai écoulé depuis l'initiation du traitement, du délai écoulé depuis la dernière prise, de l'âge du patient et du diagnostic. Pour un score psychotrope supérieur à 17, on observe une dégradation du score sur simulateur de conduite et potentiellement un seuil de risque à prendre en compte. Au total, la prise de médicaments psychotropes n'est pas obligatoirement synonyme d'inaptitude à conduire, y compris pour des traitements de niveau 3. Le score des pictogrammes de l'ordonnance systématiquement effectué par questionnement de données (data mining) permet au patient de se situer sur une échelle de risque. Il permet d'orienter les patients avec un score supérieur ou égal à 17 vers une séance d'éducation thérapeutique. Le score des pictogrammes de l'ordonnance ne rend compte que de l'effet traitement. Comparé au score de conduite sur simulateur, il peut permettre de différencier les effets liés à la pathologie de ceux des psychotropes. Il peut permettre une réévaluation du traitement pour les patients devant conduire. Il ne se substitue pas aux tests psychotechniques, mais peut les compléter dans un dimensionnement élargi et médicalisé. Les personnels soignants sont sensibilisés au risque conduite et disposent d'un critère objectif pour informer les patients avant leur sortie temporaire ou définitive d'hospitalisation. Il permet aussi de les orienter vers un avis médical, pharmaceutique complémentaire. As there is a case-law sentencing the lack of information to the patients who drive, we propose to clinically stabilized patients, sessions of therapeutic education. A driving simulator was used as therapeutic education tool and driving assessment tool. At the same time we calculated a score called pictograms' score corresponding to the sum of risk level of each psychotropic driving-impairing medicine of the patient's prescription. Driving skill scores were then compared to the calculated pictograms' score. 15 stabilized outpatients (depressive, bipolar or schizophrenic), (8M, 7F, 50.67 ± 6.53 years old), having a French B driving license since 29.53 ± 8.16 years, without somatic pathology and receiving psychotropic medications at usual dosages gave their consent and entered the study. 15 healthy control subjects (8H and 7F of 32 ± 8.67 years and 13.07 ± 7.94 years of license) taking no medication (with exception for hormonal contraception for women) were also tested for driving skills on the driving simulator used by the French Driving Schools ran on a desktop computer. The pictograms' score is the weighted sum of the regulatory levels of harmonized warning pictograms for all the psychotropic prescribed. The average simulator driving skills scores of the patient group are significantly lower than those of the healthy control group with 64.67 ± 10.40 (32 to 82) and 79.67 ± 6.84 (62 to 92), respectively (P = 0.0018). While 20% of the patients in our sample failed (score ≤ 50/100), 74% have comparable simulator driving skills as to the healthy subjects. In the previous 12 months before the study, their background was some road accidents among patients but only excess speed tickets for the healthy control subjects. The psychiatrists, including a doctor certified for the medical check of driving license, observed that the therapeutic education sessions are useful in moving the patient "in the right way" by overcoming his "innner conflicts", and fears when driving. The pictograms' score of the prescription allow us to measure the risk of multiple medications. It is analyzed taking into account the type of molecule, the dosage, the time passed since the initiation of treatment and since the last dose, the age of the patient and the diagnosis. For a psychotropic score greater than 17, we observed a worsening of the driving simulator score and potentially a risk threshold to be taken into account. Guidelines that physicians use to assess fitness for driving are limited in their currency, and applicability. All in all, the pictograms' score of the patient's prescription help him to understand the risk scale and act more safely. We use the pictograms' score calculated by data mining in our health institution to refer patients with a score greater than or equal to 17 to a therapeutic education session. The pictograms' score reflects only the treatment effect. With regards to the simulator' driving score, the pictograms' score differentiates the effects of the pathology from side effects of psychotropic medications on driving. Thus, it can help medication checking and reduce risk for patients who needed to drive. [ABSTRACT FROM AUTHOR]

[Display omitted] On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. The outbreak caused a worldwide impact, becoming a health threat to the general population and its professionals. To date, there are no specific antiviral treatments or vaccines for the COVID-19 infection, however, some drugs are being clinically tested. The use of these drugs on large scale raises great concern about their imminent environmental risk, since the elimination of these compounds by feces and urine associated with the inefficiency of sewage treatment plants in their removal can result in their persistence in the environment, putting in risk the health of humans and of other species. Thus, the goal of this work was to conduct a review of other studies that evaluated the presence of the drugs chloroquine, hydroxychloroquine, azithromycin, ivermectin, dexamethasone, remdesivir, favipiravir and some HIV antivirals in the environment. The research indicated the presence of these drugs in the environment in different regions, with concentration data that could serve as a basis for further comparative studies following the pandemic. [ABSTRACT FROM AUTHOR]

Drugs and alcohol have been featured in Canadian history as critical commodities that influenced legal decisions, social interactions, medical options, and even trade decisions. Canadian historians have examined alcohol, drugs, temperance reformers, and intoxicated Canadians in ways that deepen our understanding of how mind-altering products have influenced our Canadian values and how those ideas have changed over time. In this historiographical article, I examine how Canadian historians have responded to trends in historical scholarship that embrace a focus on social history, labour, women, medicine, colonialism, and culture. I argue that alcohol and drugs are ubiquitous in these historiographical shifts but that the uneven pace of decriminalizing intoxication has also led to new sources of information, new historical voices, and perhaps the need to rethink how our attitudes towards psychoactivity have affected our understanding of Canadian history. [ABSTRACT FROM AUTHOR]