The consumption of psychotropics in France and some european countries

The consumption in France of psychotropic drugs, of all classes, except for neuroleptics, is great, even very great, and largely superior to that observed in neighbouring European countries such as Germany, Spain, Italy and the United Kingdom. With regard to hypnotics and anxiolytics, 5 to 7 per cent of the French adult population consumes them regularly. The percentages rise with age, among females, and with the presence of unfavourable medical-social conditions. The consumption of this class of therapeutic drugs has remained stable for about ten years. The consumption of antidepressants regularly grows at a rate of about 5 per cent per year, essentially linked to the consumption of serotonin-recapture inhibitors and especially fluoxetine, currently prescribed by general practitioners in about 60 per cent of cases. The factors responsible for the strong French consumption of psychotropic drugs and the divergences with our European neighbours are complex, numerous, and poorly analysed for lack of valid comparative studies. Better prescribing practices require specific initial and continuous training to take into account the realities of everyday medical practice.     

Is psychologists' involvement in the prescribing of psychotropic medication really a new activity?

How involved in the process of prescribing psychotropic drugs is the average practicing professional psychologist today? The answer is "far more than most people realize." Five hundred ninety-six practicing psychologists responded to a survey reporting the types of professional activities in which they regularly engage. Virtually all responding psychologists reported they were involved in making recommendations for medication evaluations, consulting with physicians about which medications to use with specific patients, and discussing medication-related issues with patients. A generally agreed-on model of psychopharmacology training for professional psychologists should emerge over the next 5 to 10 years. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Esophageal involvement after tetracycline ingestion

Between 1985 and 1992, 81 spontaneous oesophageal injuries associated with tetracycline were notified to the French Regional Pharmacovigilance Centres. The side effects were oesophageal ulcers (79 per cent), esophagitis (11 per cent) and dysphagia (10 per cent). Esophagitis and dysphagia appeared sooner (4 days) than the ulcers (15 days). The mean age of the patients was 29 +/ 13 years and 73 per cent were women. In 92 per cent of cases, the recommendations for administration were not observed (medication taken at bedtime with not enough or without water). With 96 per cent of patients, doxycycline was the tetracycline in question; this prevalence could be explained by its irritant and cytotoxic properties. The oesophageal injuries were 22 times more frequent with capsules than with tablets, because of their easier adhesion to the oesophageal surface. Oesophageal injuries are potentially serious and must be avoided by clear information to patients and prescribers on tetracycline administration; consumption in the middle of a meal with an adequate quantity of water and never less than one hour before bedtime.     

The tertiary effect of psychotropic drugs. Results of an anthropologic study conducted in southwestern France among elderly consumers

This article presents part of the results of a research conducted in the South-west of France on consumption by elderlies of psychotropic drugs. Two institutions have been chosen. The author was seeking to measure the consumption of psychotropic drugs before and after institutionalization, based on a medical questionnaire distributed to doctors working in these institutions. The author then examines the impact of this consumption on social relations, at home and within institutions, from an anthropologic perspective. Elderlies, members of their families, as well as doctors and other parties concerned by this consumption have been questioned during semi-directed interviews. Other than the general consumption of psychotropic drugs in the two institutions which the author attempts to understand the extent, only modifications in family relationships after the taking of drugs at home are exposed in this article.     

Sclerosing encapsulating peritonitis--a review

OBJECTIVE: To determine the pattern of use of psychotropic drugs in Sydney nursing homes. DESIGN: Survey of data from medical records of residents and interviews with residents and staff. SETTING: Central Sydney Health Area, June to December 1993. PARTICIPANTS: All residents of 46 of the 47 nursing homes in the western sector of the health area. MAIN OUTCOME MEASURES: Psychotropic drugs used regularly or as required. Degree of cognitive impairment and depression rated on interview with residents, using Mini-Mental State Examination and Geriatric Depression Scale. Behavioural disturbances reported by staff. RESULTS: Most residents (58.9%) were taking one or more psychotropic drugs regularly and another 7% were prescribed these drugs as required. Neuroleptics were taken regularly by 27.4% and as required by a further 1.4% (at least one dose in the previous four weeks), but doses were equivalent to more than 100 mg/day of chlorpromazine for only 8.8%. Neuroleptics were more likely to be given to residents with greater cognitive impairment and more disturbed behaviour. Other psychotropic drugs in regular use were: benzodiazepines (32.3%); hypnotics (26.6%); antidepressants (15.6%); and anxiolytics (8.6%). At least half of antidepressant doses were subtherapeutic. Of 874 residents who responded to a depression questionnaire, 30% scored as significantly depressed; one-third of these were taking antidepressants. CONCLUSIONS: The percentage of residents in Central Sydney nursing homes who were taking neuroleptics, hypnotics or anxiolytics is among the highest reported from geriatric institutions around the world. Prescribing practices in Australian nursing homes need to be reviewed.     

Increasing incidence of carcinoma of the gastric cardia in Sweden from 1970 to 1985

Several American, Japanese and European centres have reported an increase in carcinoma of the gastric cardia, contrary to the general trend in the incidence of gastric cancer. The aim of this nationwide population-based study was to describe trends in the incidence of tumours of the gastric cardia in Sweden over the 16-year period from 1970 to 1985. The Swedish cancer register, which is more than 95 per cent complete, was used to identify cases. There were 1514 men and 481 women with cancer of the gastric cardia. The age-standardized rates increased in men from 1.9 per 10(5) population in 1970-1973 to 3.0 per 10(5) in 1982-1985, corresponding to a mean annual increase of 2.5 per cent (95 per cent confidence interval (c.i.) 1.6-3.4 per cent). In women, the age-standardized rates increased from 0.5 per 10(5) in 1970-1973 to 0.8 per 10(5) in 1982-1985, the mean annual increase being 0.9 per cent (95 per cent c.i. 0.0-1.8 per cent). The highest incidences were found in southern Sweden, contrary to the geographical distribution of gastric cancer in general, which shows a south-to-north gradient. The disparate epidemiological features of cancer of the cardia and gastric cancer at other sites suggest that the aetiologies may also be different. Since little is known about the aetiology of cancer of the cardia, and the incidence seems to be rising rapidly, analytical studies are urgently needed.     

Trends in registered psychiatric morbidity and forecasting psychotropic drug needs in Bulgarian hospitals

Registered psychiatric morbidity in Bulgaria as a whole and particularly in Plovdiv, the second largest region of the country, was assessed. Three aspects of psychotropic drug usage were analysed, namely, changes in registered psychotropic drugs, the prescribed daily dose (PDD) values for 2 years, and the preferred therapeutic schemes, and drug usage and needs in a psychiatric hospital with 365 beds. This was done by time series analysis for evaluation of psychiatric morbidity and drug consumption data, calculation of PDD for psychotropic medicines, and, based on a modification of the World Health Organization's morbidity method, assessment and prediction of drug use and needs in Plovdiv hospital. The results indicated that the registered morbidity had increased by 4% over the period 1989-93 to 2,427 psychiatric patients per 100,000 people. The increased consumption of especially benzodiazepines and sedative medicines was analyzed. Diazepam was prescribed the most often (91.1%), followed by levomepromazine (86.4%), haloperidol (82.7%), etc. Future drug consumption in Plovdiv hospital is expected to decrease because therapeutic practice in hospitals has been revised and improved on the basis of the World Health Organization's recommendations.     

Cultured fucosidosis fibroblasts: a simple technique demonstrating storage of tritiated-fucose labeled material

Nonsteroidal anti-oestrogenic drugs, tamoxifen and clomiphene citrate, at concentrations higher than 0.001 mug/ml reduced the colony forming ability of cells derived from a rat uterine adenocarcinoma in vitro. The 50 per cent inhibitory dose of these drugs was about one-hundredth of that of sex steroids. When the cells were treated with combinations of these nonsteroidal anti-oestrogenic drugs and the 50 per cent inhibitory dose (8 mug/ml) of progesterone, a synergistic effect on the inhibition of colony formation was observed. In contrast to progesterone, oestradiol-17beta (the 50 per cent inhibitory dose of which was about 16 mug/ml) suppressed additively the colony formation only in combination with low doses of anti-oestrogenic drugs.     

Large increase of Langerhans cells in human skin lymph derived from irritant contact dermatitis

The pharmacokinetic profile of a sulphamonomethoxine-trimethoprim (SMM-TMP) combination was investigated in five horses. The combination was administered intravenously, intramuscularly and orally at a constant dose of 20 mg SMM plus 4 mg TMP kg-1 bodyweight. Following intravenous administration both drugs dispersed rapidly with distribution half-lives of about 12 minutes for SMM and about 18 minutes for TMP. Elimination half-lives for intravenous, intramuscular and oral administration were closely similar, indicating that elimination was independent of administration route. Bioavailability of the drugs in aqueous solution was good: about 72 per cent and 84 per cent for SMM and about 84 per cent and 98 per cent for TMP following intramuscular and oral administration, respectively. It is concluded that SMM-TMP administered orally once a day at 20 mg and 4 mg kg-1 bodyweight, respectively, maintains therapeutic concentrations, whereas twice daily intramuscular administration would be more effective for treating systemic infections in the horse than the once a day regimen usually adopted in veterinary practice.     

The 'double' Michaelis-Menten equation: estimation of parameters

When the concentration dependence of an enzymic reaction or a transport process can be described by the sum of two Michaelis-Menten terms, reliable data that relate reaction rate and substrate concentration can be obtained even when as much as 70 per cent of substrate was consumed during the assay. Each data pair consists of the average reaction rate during an assay and the concentration where the instantaneous reaction rate was equal to the average rate. Although that concentration cannot be computed exactly (as it depends on the four kinetic parameters), it may be computed in a good approximation as if the reaction followed the simple Michaelis-Menten relationship. The relative error in the approximated concentration for 1 less than or equal to K2/K1 less than or equal to 10(5) and 10(-2) less than or equal to V2/V1 less than or equal to 10(2) did not exceed 5 per cent up to 50 per cent of substrate consumption, and did not exceed 10 per cent up to 70 per cent of substrate consumption.     

Gas bubble disease in farmed fish in Saudi Arabia

Four outbreaks of gas bubble disease were encountered among farmed fish in Saudi Arabia. Two of them occurred among subadult (52.5 g) saltwater tilapia (Oreochromis spilurus), the first affecting about 50 per cent of the stock and resulting in about 30 per cent mortality, and the second affecting about 25 per cent of the population with about 5 per cent mortality. Another outbreak occurred among adult (270 g) brackish water (0.5 per cent salinity) tilapia (Oreochromis niloticus), affecting about 40 per cent of the population with about 25 per cent mortality. The fourth outbreak occurred among three-month-old (15 g) grouper (Epinephelus fuscogutiatus) and resulted in 10 per cent mortality. In all cases the total water gas pressure ranged between 111.2 and 113.4 per cent saturation and nitrogen was supersaturated while oxygen was undersaturated. The outbreaks were alleviated by reducing the gas pressure by splashing the source water or by switching to a source of water with lower gas pressure. However, in O niloticus the conditions of gas supersaturation resulted in a heavy infection by monogenetic trematodes which was treated with formalin at 40 mg/litre for seven hours on five successive days.     

Longitudinal prescribing patterns of psychotropic drugs in nursing home residents.

Changes in the use of psychotropic drugs in a large nursing home were examined both in terms of usage for the total facility and in longitudinal changes within individuals. Data for the nursing home showed a gradual increase in use of antidepressants; a decrease in use of antianxiety medications and of sedative-hypnotics. Changes in the number of residents prescribed antipsychotics were not marked. Data within residents showed a great variability in number of psychotropic drugs used, in number of changes in dosage, and in specific patterns of medication change. The first drug change after admission (excluding day of admission) was more likely to involve initiation rather than discontinuation of psychotropic drugs. The medications studied were used over 4–7 months on the average, covering 20–30% of the resident's nursing home stay. The findings suggest that there is continued monitoring of psychotropic medications in the nursing home. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Amoebic liver abscess in Thailand, clinical analysis of 418 cases

From 1975 to 1983, 418 cases of amoebic liver abscess were admitted to the Department of Medicine, Siriraj Hospital without definite increase or decrease in the overall incidence and without seasonal preponderance. The age range was 16-81 yrs and mean age 42.4 yrs. Male to female ratio was 5:1. Pertinent clinical features were pain, fever and hepatomegaly with predominant involvement of the right lobe. Principal treatment consisted of needle aspiration combined with amoebicidal drugs, i.e. metronidazole, tinidazole and ornidazole. The efficacy of each was similar. Surgical drainage was required in only 2.1 per cent of uncomplicated cases and mortality rate was 0.7 per cent. Ruptures into pleural, pericardial and peritoneal cavity were found in 15.4 per cent and secondary infection in 11.9 per cent. Mortality rate of cases with complication was 7.14 per cent. Length of hospital stay was 12.8 days for the uncomplicated cases and 24.1 days for cases with complications (excluding the nonsurvivals).     

Insights into the mechanism of heterodimerization from the 1H-NMR solution structure of the c-Myc-Max heterodimeric leucine zipper

Drawing on data from a morbidity survey of sampled households in 25 small villages in Espirito Santo, Brazil, this article is concerned with reports of "nerves" (nervos) or nerve problems (problema de nervos). Reported cases of nervos (30 percent of all reports of illness) included a variety of symptoms: insomnia, body pains, dizziness, trembling, weakness, and emotional states ranging from feelings of sadness to anger. In one-third of the accounts, "overwork" was mentioned as the main cause, due both to its direct physical effect and to stress related to economic hardship and responsibility. In 88 percent of the cases, the afflicted person regularly used at least one psychotropic drug to relieve symptoms. Daily use of drugs occurred in 68 percent of the cases, and in 47 percent of cases people were reported as "dependent" on the drugs. The extensive use of psychotropic drugs suggests medicalization of nervos, creating a sick role for patients and keeping at an individual level the problems resulting in nervos.     

Health indicators and risks among people experiencing homelessness in Melbourne, 1995-1996

During the study's first stage, 284 homeless people from crisis and long-term accommodation sites were surveyed using stratified, systematic sampling. The second stage involved a survey of a convenience sample of 100 homeless people from squats and the streets. Participants completed a questionnaire, Mantoux testing was performed and blood taken for gamma-interferon assay, liver and renal function tests. The group's health status was poor, with 72% experiencing medical conditions in the preceding two years and 77% symptoms in the month prior to interview. Bronchitis, asthma and gastroenteritis were the most commonly reported conditions; productive and persistent coughing, shortness of breath and wheezing the commonest symptoms. Twenty-one per cent had Mantoux reactions 15 mm or greater, 28% a raised GGT and 19% a raised ALT. Seventy-seven per cent smoked, 74% were current drinkers, 28% had injected drugs at some time in their lives and 14% were regularly injecting drugs. Forty-four per cent had experienced mental illness, 49% of whom reported depression and 15% schizophrenia. Homeless people in Melbourne have poor health status and engage in behaviours that place their health at risk. The high number of respiratory and gastro-intestinal complaints, the high level of cigarette smoking and injecting drug use (IDU) and the proportion likely to be infected with Mycobacterium tuberculosis (MTb) are all issues with important health consequences. Participants recruited from the street had significantly poorer health and engaged in more risk behaviours than those from accommodation sites; those from the accommodated sample were more likely to be infected with Mtb.     

Perinatal observations on the etiology of congenital dislocation of the hip

At least 1 per cent of all newborn infants in the United Kingdom have CDH (Fig 10). Among these infants, approximately 85 per cent are normally formed and 15 per cent malformed. Among the normally formed infants, 90 per cent of the CDH are of the Grade 1 type, and 10 per cent of Grades 2 and 3. Such infants have a perinatal mortality of about 5 per cent. In contrast, among the malformed infants, about 50 per cent are CDH Grade 1, and 50 per cent Grades 2 and 3; their perinatal mortality is around 70 per cent. In other words, a much higher proportion than usual of the severe grades of CDH are found among the infants with a high perinatal mortality.     

金属管式换热器在气烧石灰竖窑上的应用

气烧石灰竖窑针对窑型产能较低、能耗较高的弊端,韶钢在新建气烧石灰竖窑上采用的双预热技术,使窑的产量提高47.5％,活性度提高每10min在20ml以上,能耗降低35.62％,经济效益明显.     

Importance of the evaluation of food consumption in the risk of exceeding the permissible daily doses for poisons potentially contained in food

The Codex Alimentarius in its General Principles committee proposes the definitions of risk assessment and risk management linked to ingestion of food additives and food contaminants. Moreover, three European directives imply for all member states an evaluation of food additives intakes by general population and by possible "at risk groups of consumers". This work is conducted in the general case of European Scientific Cooperation and is coordinated by United-Kingdom. This paper describes the French approach, using a step-by-step procedure to evaluate food additives consumption. It emphasizes the importance of scientific works in this field of research to obtain french datas about french consumptions.