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Objective: The aim of this study was to investigate adverse events related to the administration of Covishield vaccine from the AstraZeneca laboratory in volunteers vaccinated at the Dermatology Hospital of Bamako. Methodology: This was a Phase IV clinical trial involving volunteers vaccinated at the Dermatology Hospital of Bamako from April to June 2021. Scientific and ethical aspects were reviewed and addressed. The proposal for this study was approved by the scientific committee of the Hôpital de Dermatologie de Bamako. Results: A total of 1099 volunteers were included in the study. The median age of participants was 48 years (18-93 years) with a sex ratio of 1.81 (708/391). In all 90.2% of the 1219 adverse events were injection-site pain. Other adverse events were headache, tiredness, and muscle pain, with 3.2% (39/1219), 2.4% (29/1219) and 1.8% (22/1219) respectively. Only one case of diarrhea was reported, 0.08% (1/1219). Conclusion: Adverse events to this vaccine were mostly moderate and temporary but vary according to the population vaccinated individuals. [ABSTRACT FROM AUTHOR]

Sacubitril/valsartan (S/V) is the first commercially available angiotensin and eneprilysin receptor blocker worldwide, first approved by the United States Food and Drug Administration in 2015. It presents a clear superiority to renin-angiotensin-aldosterone inhibition alone in terms of reduction in all-cause mortality and cardiovascular mortality in heart failure patients with reduced ejection fraction following the "PARADIGM-HF" study. Therefore, it remains essential to understand its effects on the heart and off target. This approach is crucial not only to minimize potential adverse effects, but also to take full advantage of the benefits that V/S can offer in the management of heart failure. [ABSTRACT FROM AUTHOR]

Copyright of Orthodontie Française is the property of John Libbey Eurotext Ltd. 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 use of oral antiseptics, in the form of toothpaste or mouthwash, can modify the oral flora. It is important to understand the effects of these antiseptics on the ecology of the oral biofilm - and on health in general. These changes can be induced by both therapeutic and preventive applications. The effects can be seen in the oral cavity, the respiratory system and in the devices used during treatment, particularly orthodontic treatment. [ABSTRACT FROM AUTHOR]

During pregnancy, maternal thyroid function must adapt to physiological steroid (high estrogen) and hormonal (placental hCG secretion) variations to maintain euthyroidism. The reference values of TSH and free T4 levels must be known by the clinician to diagnose accurately thyroid dysfunctions in pregnant women. Primary hypothyroidism, most often secondary to autoimmune thyroiditis, is diagnosed by an increase in TSH level, and can be responsible for maternal, obstetric and fetal complications. It requires substitutive treatment with levothyroxine. The diagnosis of subclinical hypothyroidism (moderate increase in TSH level with normal free T4 concentration) and the benefit of levothyroxine treatment are discussed in the most recent publications. Graves' disease, autoimmune hyperthyroidism linked to anti-TSH receptor antibodies, must be recognized and diagnosed in pregnant patients with thyrotoxicosis. It is associated with maternal and fetal complications, and requires treatment with synthetic antithyroid drugs: propylthiouracil is the first line therapy in pre-conception and during the first trimester of pregnancy due to the risk of more frequent and more severe embryopathies observed with methimazole/carbimazole treatment in pregnant women. Medical treatment with levothyroxine of hypothyroidism and antithyroid drugs in Graves' disease are not contraindicated during breastfeeding. [ABSTRACT FROM AUTHOR]

The topic 'Sulfa-Drugs in secondary school chemistry' has been developed in cooperation of three high schools (Kantonsschulen). Three essential aspects are covered that ideally complement each other: 1. The synthesis of sulfamethoxazole – an antibiotic 'without side effects' – as a practical course in a school laboratory; 2. An introduction to the topic 'drug design' with the question of structure, effect and side effects of sulfonamides; 3. A detailed answer to the question of how side effects can be avoided by the design of drugs using molecular modelling. Teaching materials on all topics can be downloaded free of charge from Swisseduc. ch (see box). The article discusses various possible approaches in high school chemistry along the lines of a well-established teaching unit on sulfonamides.

Objective: To assess women's experiences with skin-related side effects following subcutaneous low molecular weight heparin (LMWH) injections after a cesarean section, and to analyze their impact on treatment adherence., Method: A questionnaire was developed in collaboration with Cesarine, a patients' association, to explore various aspects of LMWH administration, including prevention methods, cutaneous side effects, treatment compliance, perceived constraints, apprehension, and understanding of treatment benefits. Additionally, women's opinions on an alternative oral administration approach were solicited, taking into consideration breastfeeding contraindication. The questionnaire was on the Facebook® page and blog of the association., Results: One hundred and sixty-four women participated in the survey. Among them, 139 women (84.8%) reported bruising, while 117 (71.3%) reported pruritus, erythema, or nodules at the injection site. Treatment discontinuation was observed in 36 cases (22%), decided mostly by the women themselves (77.8%). The main reasons cited for discontinuation were discomfort during injection (71.4%), skin reactions (31.4%), and a perceived lack of effectiveness (54.3%). Furthermore, 88 women (53.7%) wanted to quit the treatment prematurely, citing similar reasons. Thirty-three women (20.1%) reported oversights. For most women, the treatment was perceived as burdensome and caused apprehension. An alternative oral administration method was of interest to 131 women (79.9%). However, only 28 (17.8%) would have accepted if the medication was incompatible with breastfeeding., Conclusion: Cutaneous side effects of LMWH injections, as well as injection process itself, have a negative impact on adherence in the postpartum period following a c-section. These findings highlight the need to explore alternative to improve women's compliance and comfort., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Résumé: L'effet placebo, bien que d'individualisation finalement assez récente (le terme n'apparaît dans les dictionnaires médicaux français qu'en 1958 [1]), est aujourd'hui clairement admis et son mécanisme se trouve même expliqué [2], au point qu'il en est tenu compte dans la recherche thérapeutique comme une des justifications du rôle des groupes témoins dits « placebos ». Il est intéressant, et moins souvent souligné, que des effets indésirables sont signalés dans des proportions non négligeables dans ces groupes « placebos », ce qui a mis en lumière le concept de « l'effet nocebo ». Des polémiques récentes, notamment induites par le développement de biosimilaires, l'ont fait discuter dans les médias. Il a certainement aussi sa part de responsabilité dans un certain nombre de situations comme les pseudo-risques imputés aux ondes électromagnétiques, où interviennent par ailleurs l'action de lobbys et des pressions politiques. S'il est moins connu, il commence à être maintenant bien établi et, comme pour son pendant positif [3], la recherche scientifique a désormais pu avancer pour en expliquer les bases physiologiques. Nous nous proposons ici de faire le point des connaissances à ce sujet et d'étudier ses conséquences éventuelles qui ne sont pas négligeables. The placebo effect, although ultimately quite recent individualization (the term does not appear in French medical dictionaries until 1958 [1]), is now clearly accepted and its mechanism is even explained [2], to the point that it is taken into account in therapeutic research as one of the justifications for the role of control groups known as "placebos". It is interesting, and less often pointed out, that undesirable effects are reported in significant proportions in these "placebos" groups, which has brought to light the concept of the "nocebo effect". Recent controversies, in particular induced by the development of biosimilars, have caused discussion in the media. He certainly also has his share of responsibility in a number of situations such as the pseudo-risks attributed to electromagnetic waves, where the action of lobbies and political pressure also intervene. If it is less known, it is now starting to be well established and, as with its positive counterpart [3], scientific research has now been able to advance to explain its physiological basis. We propose here to take stock of knowledge on this subject and to study its possible consequences, which are not negligible. [ABSTRACT FROM AUTHOR]

This study aims to remind clinicians of fluoroquinolone-related tendinopathies. They are rare side effects, but which can result in functional disability. We report the case of a 79-year-old woman with a 11-year history of haemodialysis who had sudden left ankle pain and functional impairment in the ipsilateral member on day 5th after self-medication with ciprofloxacin. Comorbidities included chronic gonarthrosis, secondary hyperparathyroidism and ischemic heart disease. The diagnosis of bilateral Achilles tendinopathy and rupture of the left Achilles tendon was retained due to clinical features and confirmed by ultrasound of ankles. Ciprofloxacinassociated tendon rupture was evaluated using the French method of accountability for drug unexpected side effects or toxicity. Tendon rupture management was based on surgery followed by functional rehabilitation program with satisfactory outcome. The frequency of fluoroquinolone-related tendinopathies ranges from 15 to 20 accidents per 100,000 subjects treated, a third of whom are complicated by tendon rupture. Incidence is related to age, affecting mainly people > 60 years and involving tissular aging. Pefloxacin and ciprofloxacin are the most offending molecules. In our study, the delay in the onset of symptoms on day 5 after self-medication was consistent with literature. We detected some common contributing factors including chronic renal failure, hemodialysis and the assumption of statins and corticosteroids. Fluoroquinolone-related tendinopathies are characterized by common clinical features which allow diagnosis. They mostly affect Achilles tendon. They are bilateral in 40-66% of cases. Tendon rupture is the main complication. Management is based on surgery. It allows to restore anatomy and to prevent detrimental functional disability. We here report a rare but potentially serious fluoroquinolonesrelated side effect, exposing the patient to the risk of functional disability. Advanced age, chronic renal failure, chronic haemodialysis, concomitant use of statins and corticosteroids are common contributing factors confirmed in this study. Hemodialysis patients constitute a population at risk; hence the importance of remote monitoring after treatment with these molecules. [ABSTRACT FROM AUTHOR]

To accept the toxic side effects of any treatment, whether medical, surgical or radiotherapeutic, cannot be avoided but implies to evaluate them taking into account the severity and prognosis of the disease that is concerned. Screening, preventing and treatment of these side effects are an integral aspect of the treatment of cancers. We will here review the contribution of the cardio-oncology, a recently emerged medical specialty. Cardiac irradiation cannot be avoided when treating several cancers, most frequently left sided breast cancer. As soon as radiotherapy is considered, it is of prime importance to evaluate each patient's risk factors and to handle them. If technical progresses have led to the complete disappearance of acute side effects of radiotherapy, this is not true for the delayed ones that may occur many years after the irradiation. Hence the need for «red flags» and for a systematic follow-up. Cardiac complications of left breast irradiation concern all aspects of cardiology: diseases of cardiac rhythm, valvulopathies, heart failure, coronary and pericardial disorders.

INTRODUCTION: Obstetric hemorrhage is estimated to cause 25% of all maternal deaths and is the leading direct cause of maternal mortality worldwide. The World Health Organization recommended the use of uterotonics that should be offered for all women who will give birth but in some countries or in special situations oxytocin is not available. The goal of this study is to determine whether the 400μg dose of Misoprostol decreases the incidence of postpartum hemorrhage (PPH) of women who did not show signs of hemorrhage. METHODS: a prospective randomized double blind controlled trial was conducted between February 2012 and June 2012, among women in the active stage of labor attending the Obstetric Gynecology Department, University Hospital Farhat Hached of Sousse, Tunisia. Women with term singleton pregnancies greater than 32 weeks of amenorrhea with anticipated vaginal delivery were eligible for the study. Participants were randomly assigned to receive 400 μg sublingual Misoprostol or 2 ets of placebo immediately after cord clamping. The primary outcome measures were an estimation of blood loss including the subjective finding of vaginal hemorrhage 500 ml, the decrease of hemoglobin and hematocrit, a change in hemodynamic parameters, and the need for additional dose of oxytocin. Secondary outcomes were occurrence of possible side effects such as: headache, nausea, vomiting, pyrexia, diarrhea and abdominal pain. RESULTS: a total of 211 patients were randomized: 111 in the Misoprostol group (Cytotec*) and 100 patients in the placebo group. The two groups were similar in terms of sociodemographic characteristics. Significant difference between the 400-µg of Misoprostol and placebo group were recorded in mean postpartum blood and PPH occurrence. The difference in pre- and postpartum hemoglobin loss (expressed in grams per 100 ml) was 1.21 ± 1.05 for the Misoprostol group and 1.51 ± 0.74 for the placebo group with significant difference (p = 0.02). No differences were observed in the occurrence of headache, dizziness, vomiting, diarrhea and metallic taste but the incidence of shivering was more than twice as great among women receiving Misoprostol than among those treated with placebo with a significant difference (p = 0.01). Similarly, women who received Misoprostol had a significantly higher mean temperature after delivery in comparison with those receiving placebo. CONCLUSION: misoprostol, administered as 400 µg after delivery, appears to be effective for the prevention of post-partum hemorrhage, but side its effects appears to be significant.

Despite the evolution of foreign aid strategies, the approach based on model transfer from a donor country to a recipient remains disappointing. We want to explain this (mal)functioning through a cross-analysis of the power games from the donor to the recipient, focusing on two development models implemented in Madagascar (Payment for Environmental Services – PES – and decentralization). Indeed, if the aid is still active, it means that some of the stakeholders know how to take advantage of it. We would like to identify these stakeholders and the way they misappropriate foreign aid, while maintaining the conditions of its sustainability. To reach our goal, we introduce a typology of stakeholders and their strategies, which leads to a better understanding of the side effects of foreign aid and the obstacles to its re-assessment.

(Series Information) European Papers - A Journal on Law and Integration, 2018 3(2), 1005-1016 | European Forum Insight of 13 June 2018 | (Table of Contents) I. Introduzione. - II. Il caso. - III. Le conclusioni dell'AG Saugmandsgaard Øe. - IV. La sentenza della Corte di giustizia. - V. Le informazioni ingannevoli nel diritto dell'Unione e quale problema rilevante per il diritto della concorrenza. - VI. Conclusioni. | (Abstract) In a recent case (judgment of 23 January 2018, case C-179/16, Hoffmann-La Roche and others), the Court of Justice held that an arrangement put in place between two undertakings marketing two competing products, which concerned the dissemination of misleading information relating to adverse reactions resulting from the use of one of those medicinal products, with a view to reducing competitive pressure, constituted a restriction of competition "by object" for the purposes of Art. 101, para. 1, TFEU. The purpose of this Insight is to provide an analysis of the case, focusing on both the opinion of the Advocate General and the judgment, and to provide further examples that prove that the dissemination of misleading information in the pharmaceutical field has become a competition law problem.

INTRODUCTION: Infantile hemangioma is the most common benign tumor in infancy. Currently, oral propranolol is the treatment of choice for infantile hemangioma, but there is no consensus when it comes to its recommended dosage for this condition. Hence this study was conducted this study to find out the appropriate dosage of oral propranolol for treatment of infantile hemangioma. METHODS: A prospective study was conducted on 25 patients with infantile hemangioma, who were treated with gradually increasing dose of propranolol starting from a lower dose of 1mg/kg/day. RESULTS: 17/22(76%) patients showed regression of the tumor at the dose of 1-1.5 mg/kg/d. 5/22(24%) patients were unresponsive on lower dose and they did not respond even with the gradually escalated dose of 3-4 mg/kg/day. CONCLUSION: Propranolol in a lower dose of 1-1.5 mg/kg/day is safe and efficacious in the treatment of infantile hemangioma and the lesions which do not show initial response to the lower dose are unlikely to respond to the higher dose of 3-4 mg/kg/day.

Objective: The aim of this study was to investigate adverse events related to the administration of Covishield vaccine from the AstraZeneca laboratory in volunteers vaccinated at the Dermatology Hospital of Bamako., Methodology: This was a Phase IV clinical trial involving volunteers vaccinated at the Dermatology Hospital of Bamako from April to June 2021. Scientific and ethical aspects were reviewed and addressed. The proposal for this study was approved by the scientific committee of the Hôpital de Dermatologie de Bamako., Results: A total of 1099 volunteers were included in the study. The median age of participants was 48 years (18-93 years) with a sex ratio of 1.81 (708/391). In all 90.2% of the 1219 adverse events were injection-site pain. Other adverse events were headache, tiredness, and muscle pain, with 3.2% (39/1219), 2.4% (29/1219) and 1.8% (22/1219) respectively. Only one case of diarrhea was reported, 0.08% (1/1219)., Conclusion: Adverse events to this vaccine were mostly moderate and temporary but vary according to the population vaccinated individuals., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Résumé: Mme X, 21 ans, nous consulte car elle présente une sensation de cuisson, et une chaleur au niveau d'un tatouage réalisé la veille. Elle est allée voir un tatoueur ayant pignon sur rue dans sa ville. Cependant, elle a peur d'avoir un problème infectieux suite à la réalisation de cet acte. Cliniquement, nous mettons en évidence une plage érythémateuse très homogène tout autour de son tatouage. En fait cette réaction est très fréquente et correspond à une réaction inflammatoire secondaire à la réalisation de son tatouage. Ms. X, 21, consults us because it has a feeling of cooking, and heat at a tattoo done the day before. She went to see a tattoo artist who was well established in his city. However, she is afraid of having an infectious problem following the realization of this act. Clinically, we highlight a very homogeneous erythematous beach all around his tattoo. In fact this reaction is very common, and corresponds to an inflammatory reaction secondary to the realization of his tattoo. [ABSTRACT FROM AUTHOR]

Résumé: Le thalidomide est une molécule ayant connu un grand succès commercial en 1957 en Europe, comme sédatif non barbiturique et antiémétique chez les femmes enceintes. Cependant, elle a été rapidement retirée du marché en raison de ses effets tératogènes majeurs. L'avancée des connaissances de ses propriétés immunomodulatrices et anti-angiogéniques a redonné un regain d'intérêt thérapeutique à cette molécule. Elle est indiquée actuellement dans diverses pathologies tumorales et inflammatoires, telles que l'aphtose sévère liée à la maladie de Behçet. Par ailleurs, de nombreux effets indésirables peuvent entraver le cours du traitement par le thalidomide. Certains sont fréquents et bien connus des cliniciens. D'autres complications ne sont rapportées qu'occasionnellement, notamment la survenue d'une bradycardie symptomatique. Nous rapportons ici le cas d'un jeune homme suivi pour maladie de Behçet, chez qui un traitement par thalidomide a été indiqué pour une aphtose buccale sévère résistante aux thérapeutiques habituelles, et ayant présenté une bradycardie symptomatique comme effet secondaire amélioré après l'arrêt du traitement. Cela nous amène à mettre le point sur la nécessité de restreindre la prescription du thalidomide aux formes d'aphtoses sévères et résistantes en utilisant la dose efficace la plus faible associée à une vigilance extrême. Thalidomide is a molecule that had a great commercial success in Europe in 1957 as a non-barbiturate sedative agent and antiemetic in pregnant women. However, it was quickly taken off the market because of its major teratogenic effects. The advanced knowledge of its immunomodulatory and anti-angiogenic properties, has given a new therapeutic interest to this molecule. It is currently indicated in various tumoral and inflammatory pathologies such as severe aphtosis related to Behçet's disease. Otherwise, many adverse effects appear to hinder the course of treatment with thalidomide. Some are common and well known to clinicians. Other complications are reported only occasionally including the occurrence of symptomatic bradycardia. We report here the case of a young man with Behçet's disease. He was treated with thalidomide for a severe oral aphtosis resistant to the usual therapies. Who presented a symptomatic bradycardia as a side effect improved after stopping treatment. This allows us to highlight the need to reserve the prescription of thalidomide to severe and resistant forms of aphtosis using the lowest effective dose with extreme vigilance. [ABSTRACT FROM AUTHOR]

Résumé Les irradiations abdominopelviennes tiennent une place importante dans la prise en charge des patients atteints de cancer mais exposent aux risques d'effets secondaires aigus et tardifs, en particulier de complications néphrologiques ou urologiques. Ces effets secondaires peuvent être à l'origine d'une importante altération de la qualité de vie des patients. L'objectif de cette revue de la littérature est de détailler la physiopathologie, la symptomatologie et les principes de la prise en charge préventive et curative de la toxicité radio-induite du système urinaire, incluant les néphropathies, les urétérites, les cystites radiques et les urétrites radiques. Abstract Abdominal and pelvic irradiations play a major place in the management of patients with cancer and present a risk of acute and late side effects. Radiation-induced lesions can affect kidney or urological structures. These side effects can have an impact in the quality of life of patients. The aim of this article is to describe the physiopathology, the symptomatology, and the principles of management of radiation-induced nephropathy, uretheritis, cystitis, and urethritis. [ABSTRACT FROM AUTHOR]

Copyright of Psycho-Oncologie is the property of Tech Science 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.)

Résumé Les inflammations oculaires secondaires à une origine médicamenteuse sont très variées, et peuvent concerner toutes les structures de l’œil. Cette mise au point a pour objectifs d’aider le clinicien à évoquer cette hypothèse devant une atteinte oculaire inexpliquée et avant que les lésions ne soient définitives, de connaître le risque d’inflammation oculaire dite paradoxale, en particulier pour les anti-TNF, pouvant simuler une poussée de la pathologie inflammatoire sous-jacente et enfin de mieux connaître la toxicité oculaire des nouvelles générations de thérapie ciblées, principalement les anti-tyrosines kinases. Ocular drug side effects are very varied and can affect all the structures of the eye. The purpose of this review is to help clinicians: (i) to evoke this drug-induced toxicity yearly in the course of an unexplained ocular injury, before its damage become irreversible, (ii) to be able to recognize induced paradoxical ocular inflammation, mimicking an inflammatory pathology flare-up, especially in patient under anti-TNF regimen and (iii) to propose a more in-depth knowledge on recently described ocular toxicities from targeted cancer therapy, mainly the tyrosine kinase inhibitors. [ABSTRACT FROM AUTHOR]

Résumé L’icodextrine est un polymère de glucose dérivé de l’amidon qui est utilisé comme agent osmotique en dialyse péritonéale. Son grand poids moléculaire limite fortement son absorption sanguine et permet donc de l’utiliser dans des stases longues, puisqu’il y a très peu de dissipation du gradient osmotique. Ses bénéfices sont nombreux : optimisation de l’ultrafiltration et donc du contrôle de la surcharge hydro-sodée, notamment chez des patients anuriques, hyperperméables ou en cas de péritonite infectieuse, épargne glucidique avec moins de complications métaboliques et meilleure préservation de la membrane péritonéale, meilleure biocompatibilité. Toutefois, il possède également des effets secondaires qu’il ne faut pas méconnaître : allergies, cas de péritonite aseptique, déplétion hydro-sodée trop intense, passage sanguin d’icodextrine et de ses dérivés (notamment le maltose), avec risque d’erreurs de dosage de la glycémie capillaire et augmentation modérée de l’osmolalité plasmatique. C’est pourquoi son utilisation est actuellement limitée à une stase longue quotidienne au maximum. Malgré cela, plusieurs centres l’utilisent dans plus d’une stase quotidienne, notamment chez des patients en grande perte d’ultrafiltration ou chez qui l’épargne glucidique est essentielle. Ces patients semblent tirer des bénéfices de cette utilisation intensifiée d’icodextrine sans présenter plus d’effets indésirables. Une grande étude multicentrique (DIDo) est actuellement en cours pour tester l’efficacité et la sécurité de l’utilisation d’icodextrine dans deux échanges quotidiens chez des patients âgés et incidents en dialyse péritonéale. Par ailleurs, l’icodextrine est aussi utilisé combiné à du glucose en stase longue (ultrafiltration bimodale) avec des résultats très prometteurs en termes d’ultrafiltration et d’épargne glucidique. Icodextrin is a glucose polymer derived from starch that is used as an osmotic agent in peritoneal dialysis. Its high molecular weight limits blood absorption and is useful for long dwell since there is few osmotic gradient dispersal. Its benefits are numerous: ltrafiltration optimization and better salt and water control especially in anuric patients with a high peritoneal permeability and also in case of infectious peritonitis, glucose sparing with less metabolic complications and a better preservation of peritoneal membrane, better biocompatibility. However it should not be forgotten that icodextrin has also side effects that must be known: allergies, cases of aseptic peritonitis, overintense water and salt depletion, lymphatic absorption of icodextrin and its metabolites (including maltose) with a risk of false capillary glucose rate estimation and a moderate increase in plasma osmolality. That is why it is not recommended now to use more than one daily icodextrin dwell. Nevertheless, several dialysis units use icodextrin in more than one daily dwell, especially in patients with an important ultrafiltration loss or in those in whom glucose sparing is essential. It seems to profit them with no more side effects. A large multicenter trial is in progress to test the efficacy and safety of icodextrin dwell twice a day in elder incident patients in peritoneal dialysis (DIDo). Moreover, icodextrin is also used combined with glucose in a long dwell (bimodal ultrafiltration) with encouraging results in terms of ultrafiltration and glucose sparing. [ABSTRACT FROM AUTHOR]

Medical error is defined as an involuntary act performed by a health professional. It may be an omission error, an action that was to be and was not done, or by commission, an act that should not have been done and has been done. Deficiencies in medical knowledge would account for 2% of errors. The error does not necessarily have consequences for the patient unlike the undesirable event related to the care (EIAS), which itself is not necessarily linked to an error. Involvement in a medical error is always a difficult test for a caregiver. Lawsuits are always a test and a moment of self-doubt. The doctor who made the mistake is affected by the legal process that is taking place, with multiple impacts on his professional and personal life. He/she is called the "second victim". In a second article we will discuss the expertise that accompanies the challenge. [ABSTRACT FROM AUTHOR]

Background: Oral isotretinoin is the only drug which promotes prolonged remission or cure of severe acne. The aim of our study was to estimate the isotretinoin exposure and to evaluate the effectiveness of the Polish and Romanian pregnancy prevention. This is a comparative study of two groups of women. Methods: A retrospective, comparative study of 569 women with acne vulgaris. The study included two groups of randomly selected women during treatment and follow-up. Group I with rigorous prevention of pregnancy; Group II without this rigor. Results: We did not register any pregnancies. 1.93% used oral contraceptives, 92.79% used a condom during sex, and 7.21% of women abstained from sex. The analysis showed significant differences (p

Background: Antiretroviral (ARV) adherence of ≥ 95% is recommended for suppressing HIV. However, studies have shown that the ≥ 95% recommended level is rarely achieved. Objective: This cross-sectional community-based study sought to assess factors contributing to ARV drug adherence among adults living with HIV or AIDS. Setting: The study was conducted in a rural community in Machakos County, Kenya. Methods: The questions used for the study were adapted from the Patient Medicine Adherence Questionnaire (PMAQ), a tool grounded in the Health Belief Model. Adherence to ARV was measured using self-reports and pill counts. The perception social support was measured with a 5-point Likert scale, whereas the type and the number of side effects experienced were recorded using ‘yes’ and ‘no’ questions. We used the chi-square test to test associations and binary logistic regression to assess factors explaining dose adherence to ARV. Results: The levels of adherence of 86% using self-reports were significantly higher (p < 0.001) than the pill count of 58.6%. The immediate family was rated high in providing social support (3.7 ± 0.6) followed by social support groups (3.1 ± 0.8). A binary logistic regression analysis was conducted to predict ARV adherence (adherent, non-adherent) using social support, side effects and marital status as explanatory variables. The Wald criterion demonstrated that marital status (p = 0.019) and burden of side effects (p ≤ 0.001) made a significant contribution to the prediction of ARV adherence. Conclusion: The burden of side effects and being a divorcee are primary predictors of ARV adherence.

Management of chronic disease conditions in the elderly is challenging. They usually have many co-morbidities requiring multiple drug regimens, and memory or cognitive problems that can interfere with management. Also, they sometimes have a degree of social problems as they might often live alone, and thereby cater for their daily activities with minimal assistance. Multiple drug use combined with their fragile health predispose them to adverse drug reactions, drug-drug interactions, and direct drug toxicity from overdosing. We report and discuss the lessons learnt from the case of an elderly woman in an urban setting in sub-Saharan Africa who presented with problems of drug dosing, adverse drug effect, and drug-drug interaction that might prove useful in the future management of hypertension with angiotensin converting enzyme inhibitors.

Résumé Du fait d’une extension de leurs indications, les antipsychotiques sont des molécules que tout praticien est amené à prescrire ou à reconduire, tant dans des situations aiguës telles que certains troubles du comportement, que dans le traitement de troubles psychiatriques caractérisés comme les troubles psychotiques ou le trouble bipolaire. La prescription de ces molécules nécessite une évaluation précise de la balance bénéfice/risque en tenant compte des particularités propres à chaque situation clinique. En effet, les antipsychotiques sont associés à une augmentation de la morbi-mortalité du fait de leurs effets secondaires parfois sévères, principalement neurologiques (syndrome extrapyramidal, dyskinésies, akathisie), métaboliques et cardiovasculaires. D’une manière générale, les antipsychotiques de seconde génération doivent être privilégiés aux antipsychotiques de première génération du fait d’un meilleur profil de tolérance, et ce particulièrement en cas de prescription prolongée. Ainsi, la surveillance du traitement, tant de son efficacité sur les symptômes ciblés, que de sa tolérance, est essentielle dans la prise en charge de patients traités par antipsychotiques. Antipsychotics are commonly prescribed in the general population since they have many indications. They can be used in acute care such as agitation or behavior disorders, or to treat more characterized psychiatric disorders like psychotic or mood disorders. Consequently, any practitioner will have to prescribe or renew a prescription of antipsychotics. These treatments require a benefit/risk balance assessment taking into account the specific context of each patient. Indeed, antipsychotics have many side effects, mainly neurological (extrapyramidal syndrome, dyskinesia, akathisia), metabolic and cardiac. If these complications are poorly controlled, they could dramatically increase the morbidity and the mortality. Second-generation antipsychotics should be preferred to first-generation antipsychotics because of their better safety profile, especially in case of prolonged prescribing. Treatment monitoring, including effectiveness on the targeted symptoms, tolerance and observance, are major issues in the management of patients treated with antipsychotics. [ABSTRACT FROM AUTHOR]

The purpose of this phenomenological study was to describe the experience of sexuality of middle-aged Quebec women living with cervical cancer. Ten women accepted to take part in the study. The findings reveal a new outlook on sexuality, as these women refocus their positions on their lives, their conjugal relationships and the adverse effects of therapies. The participants expressed the will to combine feelings of love with sexual pleasures. They all felt the need to talk about the embarrassing and traumatizing effects of treatment on their sexuality. These findings raise the need for nurses to recognize these women’s sexual concerns and to further research in this area.

Résumé Les notices présentes dans les boîtes de médicaments sont complexes et souvent mal comprises. Les patients consultant en néphrologie sont majoritairement âgés et polypathologiques, et ainsi sujets à de multiples contre-indications et interactions. Nous avons voulu évaluer si ces patients lisaient les notices ou des informations sur d’autres médias comme Internet, et si cela conduisait parfois à des non-prises ou des arrêts de traitements. Un questionnaire d’observance leur était également soumis. Les notices ont été lues par 65,1 % des patients et cela a conduit à 12 % d’arrêts ou de non-prises de traitements. L’observance était considérée comme mauvaise pour 11 % d’entre eux, avec le plus souvent des retards de prise mentionnés. Il n’existait dans cette étude aucun profil type du patient non observant. Même les patients les plus jeunes (moins de 50 ans) avaient une observance correcte, n’avaient pas plus d’arrêts ni de non-prises de traitements. Les patients jeunes consultaient davantage de médias alternatifs alors qu’ils lisaient peu les notices. Les patients qui consultent les notices cherchent aussi fréquemment des informations sur d’autres médias et cela pose de nouveaux défis en santé, les données disponibles au grand public n’étant pas toujours vérifiées ni adaptées. Leaflets inside drug boxes are complex and often poorly understood. Patients consulting in nephrology are mostly old and often suffer from multiple comorbidities. As so, they are often subject to various contra-indications and drug interactions. This paper aims to evaluate if patients actually read leaflets or other medical information on others medias such as Internet and whether this could, potentially, interfere with their observance. Results showed that leaflets were read by 65.1% of patients, leading to 12% of withdrawal or not taking drugs. Furthermore, compliance to medical guidance was deemed e-read by 65.1% of patients, leading to 12% of withdrawal or not taken drugs. Furthermore, this study showed no clear profile for non-compliant patients. Even the youngest patients (under 50 years old) have had a good compliance, with not more withdrawal or not taking pills. Nonetheless, youngest patients used more often to consult alternative medias and did not read much of the leaflets’ information. Patients who were reading leaflets however, tended to search further information on other medias. This situation would create new challenges in health care, as it seems that data available on new medias are not systematically validated or adapted to the needs of the patients. [ABSTRACT FROM AUTHOR]

Résumé L’épilepsie entretient des liens historiques avec la psychiatrie que l’essor des médicaments antiépileptiques est venu réanimer. Les principales hypothèses concernant les mécanismes d’action des médicaments antiépileptiques sur les canaux ioniques (sodiques, potassiques et calciques) et sur la neurotransmission de voies glutamatergique et GABAergique sont présentées. Les auteurs présentent ensuite les propriétés thérapeutiques possibles et les effets indésirables potentiels de ces molécules sur les symptômes et les pathologies psychiatriques. À titre d’exemple, ils rappellent les indications du valproate, de la lamotrigine et de la carbamazépine dans le traitement des troubles bipolaires et évoquent l’intérêt possible de certains autres médicaments antiépileptiques dans cette maladie. Epilepsy has been linked to psychiatry for more than a century and a half. Over the past few decades, serendipitous discoveries have shown the efficacy of some antiepileptic drugs with certain mental disorders. As such, a new age seems to be born in neuropsychiatry. In this paper, the authors summarize the main hypotheses regarding the mechanisms of action of antiepileptic drugs on neurotransmission (glutamate and GABA pathways), and on neuronal ionic channels (Sodium, Potassium, Calcium, Chlorine). Moreover, the main positive effects on mood, sleep, anxiety, addictions observed under these drugs are listed. On the other hand, the potential psychiatric side effects (depression, stress, psychotic disorders, impulsivity) induced by antiepileptic drugs are also reviewed. Finally, the authors comment on the use of antiepileptic drugs in the curative and the maintenance treatment of bipolar disorders. [ABSTRACT FROM AUTHOR]

Myocarditis is a relatively uncommon and underdiagnosed heart disease. Its clinical presentation is variable, from pauci-symptomatic to a symptomatology of sudden chest pain. The latter mimics cardiological emergencies and must therefore be quickly discerned to guide the rest of the treatment. The treatment is mainly supportive and rarely directly etiological. This is a pathology that resurfaced with the onset of the COVID-19 pandemic but also with vaccination. We present here the case of a mRNA SARS-CoV-2 vaccine-induced myocarditis whose clinical manifestations impose a rapid decision concerning the differential diagnosis with an acute coronary syndrome.

Follicular lymphoid hyperplasia induced by dasatinib is an entity recently described. It is sometimes difficult to rule out the diagnostic of small B-cell lymphoma. Usually, the node is swollen, with follicular architecture conserved, composed by germinal centers with variable size and shape, with a hight number of mitoses and tingible bodies macrophages inside. Follicular lymphoid hyperplasia is isolated or associated with multiple reactive patterns. The immunohistochemical profil of germinal centers is CD20+, CD10+, BCL6+, BCL2-. Swollen node disappears in a short time after dasatinib discontinuation. Clinicians and pathologists need to be aware of this entity, so as not to avoid mistakenly suspect lymphoma when lymphadenopathy occurs in a patient with chronic myeloid leukemia treated with dasatinib., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Résumé Propos En 2009, la Haute Autorité de santé signalait de nombreuses prescriptions d’inhibiteurs de la pompe à protons (IPP) injustifiées. Notre objectif était d’analyser les modalités de prescription des IPP prescrits aux patients préalablement à leur hospitalisation dans un service de médecine interne. Méthodes Un recueil prospectif des prescriptions a été réalisé à l’admission de tous les patients pendant 5 mois. La conformité (indication, durée de traitement et posologie) des prescriptions d’IPP a été analysée par rapport aux autorisations de mise sur le marché (AMM) et recommandations françaises de bon usage. Les informations étaient obtenues grâce au dossier médical et aux médecins généralistes. Résultats Nous avons recueilli 173 prescriptions d’IPP. Cinquante-six (32 %) étaient en accord avec les indications d’AMM et parmi elles 15 (9 % du total) étaient aussi conformes aux recommandations en termes de posologie et de durée de traitement. Cent-six prescriptions (61 %) n’étaient pas conformes avec quatre-vingt-onze prescriptions (53 % du total) hors AMM ; parmi elles 33 % pour de simples troubles dyspepsiques, 23 % pour la prévention de lésions induites par les anti-inflammatoires non stéroïdiens chez des patients sans facteur de risques et 17 % pour la prévention de l’ulcère de stress. Cinquante-deux prescriptions (30 %) n’ont pu être évaluées faute de données complètes. Conclusion Une grande majorité des prescriptions d’IPP de patients hospitalisés est non conforme aux recommandations. Outre la poursuite des actions de prévention contre les prescriptions abusives, des stratégies de sevrage ou de remplacement des IPP devraient être mise en place pour réduire l’impact iatrogène et économique des IPP. Purpose In June 2009, the national French authority for Health reported many off-label uses of proton pump inhibitors (PPI). Our objective was to analyse the justification and modalities of PPI prescriptions in patients before their admission in a department of internal medicine. Methods Data were prospectively collected during 5 months. At admission, all prescriptions of PPI by general practitioners (GP) were recorded. The accordance of the prescriptions with the marketing authorization indications and the French guidelines in terms of duration of treatment or dosage was analyzed. These informations were obtained from computerized medical records and, if necessary, by contacting GPs. Results We collected 173 prescriptions. Fifty-six (32%) were in accordance with marketing authorization indications and, among them, 15 prescriptions (9% of all) respected the French guidelines about dosage and duration of treatment. One hundred and six prescriptions (61%) were not adequate and among them an off-label use was notified in 91 (53% of all); among them 33% for simple dyspeptic disorders, 23% for the prevention of NSAID-induced lesions in patients without risk factors, and finally 17% for the prevention of stress ulcer. Fifty-two prescriptions (30%) were unclassified due to incomplete data. Conclusion Our study showed that a vast majority of the prescriptions for PPIs are not in accordance with French guidelines. Preventive actions against abusive prescriptions, withdrawal strategies or replacement of already prescribed PPIs should be implemented to reduce the risk of side effects and the economic impact of long term use of PPIs. [ABSTRACT FROM AUTHOR]

In the attempt to harmonize clinical practices between different French transplantation centers, the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) set up the fourth annual series of workshops which brought together practitioners from all member centers and took place in September 2013 in Lille. Here we report our recommendations regarding the use of immunosuppressive treatment in the prevention of graft versus host disease: report by the SFGM-TC. [ABSTRACT FROM AUTHOR]

Objective The French National Pharmaceuticals Agency (ANSM) has recommanded in July 2012 not to break the cold chain before using succinylcholine (Celocurine®). Research objective: to understand the pre-clinical evolution of the conservation modes of this curare. Research type Descriptive study before (year 2011) and after (year 2012). Patients and method Online survey to French Samu/Smur. Data collected: SMUR location, conservation method at clinical base, in the mobile unit (UMH) and at the patient. Principal decision criteria: evolution of the conservation modes before and after the recommendation (qualitatives variables compared with a Fisher test). Results Out of 101 SAMU/SMUR, 62 answered. Conservation modes of succinylcholine vials were significantly different (P < 0.001). Proper conservation was observed in 26 % of the cases before and 43 % after. Mobile units (UMH) equipped with a fridge increased from one out of two to 77 %. The lack of conservation modes passive or active on UMH went from 31 % to 3.4 % with isotherms bags with ice when a fridge was not available. The destruction of capsules at current temperature in a 24-hour period increased: 22 % before, 47 % after (P = 0.04). Conclusion After recommendations from ANSM, conservation modes and destruction of succinylcholine in a prehospital environment were significantly impacted. [ABSTRACT FROM AUTHOR]

Copyright of Les Cahiers de l'Année Gérontologique is the property of Lavoisier 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.)

Coronavirus disease 19 (COVID-19) was first observed in Wuhan, China. The disease is caused by a virus (SARS-CoV-2), which spread around the world within a matter of weeks, leading to a large number of deaths. While the health crisis was managed on the ground, the scientific community focused on finding a means to stop it. Vaccine candidates such as the mRNA vaccines (Pfizer BTN162b2 and Moderna mRNA-1273), started to emerge. As these treatments came on the market recently, there is still concern about potential side effects, among them, Herpes Zoster Ophthalmicus (HZO)., (Copyright © 2022. Published by Elsevier Masson SAS.)

Background: Hypertension is a serious public health challenge in both economically developing and developed countries. Patients on outpatient medication for hypertension at Vanga Hospital in the Democratic Republic of Congo (DRC) often present with uncontrolled hypertension and some with hypertension emergencies. On enquiry, the problem appeared to revolve around compliance. Method: The study was a qualitative, descriptive study using the focus group interview technique for data collection. Subjects were purposely selected. Interviews were conducted from 23 March to 19 July 2006. Three focus groups were formed: The first was heterogeneous in terms of gender (five males and three females), the second homogeneous (six males) and the last also homogeneous (six females). The group members varied with respect to characteristics such as place of residence, occupation and educational standard. The data collected were analysed using the thematic analysis method within grounded theory. Results: Five themes emerged as possible explanations for non-compliance: Side effects discouraged patients from taking medication; patients took medication only when they experienced perceived symptoms of hypertension; poor knowledge of the disease and the medication used; lack of support by family members; and difficulty in obtaining antihypertensive medication. Conclusion: Side effects of the medication, lack of information and support, difficulty in obtaining the medication and the fact that the disease is mainly silent played a major role in the poor adherence to hypertension medication. Sustained health promotion and education should be undertaken at all levels of patient contact to ensure good compliance.

Copyright of Reanimation is the property of Lavoisier 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.)

Résumé: L’objectif de notre étude était d’évaluer la sexualité chez des malades souffrant de schizophrénie et de trouble bipolaire, de relever les facteurs corrélés aux dysfonctions sexuelles, d’établir une comparaison entre les deux types de malades en fonction des dysfonctions sexuelles et de proposer, au vu de nos résultats et des données de la littérature, des recommandations pour la prise en charge et la prévention des dysfonctions sexuelles chez de tels malades. L’étude a consisté en une enquête auprès des sujets ayant consulté en psychiatrie, durant les mois de mai et juin 2005 au CHU Hédi Chaker à Sfax en Tunisie et qui étaient atteints d’une schizophrénie ou d’un trouble bipolaire. Nous avons utilisé, comme outil psychométrique, le Sexual Behavior Questionnaire (SBQ). Notre étude a concerné 61 cas, que nous avons répartis en deux groupes, en vue de les comparer : le groupe 1 (G1), celui des malades atteints de schizophrénie (n =30), et le groupe 2 (G2), celui des malades atteints de trouble bipolaire (n =31). La moyenne d’âge de la population étudiée était de 37,3ans. Le taux des mariés était de 47,5 % (20 % pour G1 versus 74,2 % pour G2 ; p <0,001). Les dysfonctions sexuelles ont été rapportées par 73,8 % des patients. Les malades atteints de schizophrénie ont plus fréquemment rapporté de dysfonctions sexuelles que les malades bipolaires (p =0,01). Malgré sa fréquence, la dysfonction sexuelle n’a pas été abordée avec le médecin traitant dans 79,3 % des cas. Le taux de ceux qui ne présentaient pas de dysfonctions sexuelles avant la mise sous traitement était de 72,1 %. Tous les malades dans G1 et 87,1 % dans G2 étaient sous traitement neuroleptique classique. Il n’y avait pas de corrélation, dans notre étude, entre les neuroleptiques classiques et les dysfonctions sexuelles ; mais une telle corrélation a été rapportée dans plusieurs publications ; ce qui montre l’intérêt de la prescription préférentielle des antipsychotiques atypiques ayant une faible interférence sur le métabolisme de la prolactine, pour prévenir ou réduire de tels inconvénients. La prise en charge et la prévention devraient reposer aussi sur l’information et l’éducation des psychotiques chroniques, en matière de sexualité, dans le cadre des programmes de réhabilitation. [Copyright &y& Elsevier]

Aim: A better understanding of breast cancer patients' perceptions about their general practioners (GP) roles in the intercure management, so as to identify the obstacles to GPs intervention, while the public will, the epidemiology and the medical demography trend towards the need to involve GPs. Procedure: A multicentric retrospective study through 4 exploratory interviews followed by a questionnaire sent by internet to 76 breast cancer diagnosed women, undergoing chemotherapy within the 5 past years and having a GP. The results were processed through ÉpiInfo™; tests khi2 and Fisher exact. Results: The sample has been revealed particular by its high socio-educative level and by its exclusive choice for the gynecologist as primary care request for gynecological problems. The relationship with the general practitioner was judged positive. Concerning the chemotherapy-induced side effects during chemotherapy phase, the oncologist was considered as the primary care request (46%) and the general practitioner came in second care request (34.2%), preferentially for pain management (statistical trend). For 13.2% of patients, the doctor with particular practice was identified as a significant intercure participant, mainly for the pain management (statistical trend). Regarding chemotherapy-induced psycho-affective disorders, the general practitioner was the primary intercure care request (32.9%). Concerning the gynecologist, he was totally excluded from the chemotherapy follow-up, as for the chemotherapy-induced side effects (1.3%) than for the psycho-affective troubles (2.6%). Concerning the preferential general practitioner/oncologist couple, the study objectivized a coherence in the choice of these two participants, as in the patients representations of the idealistic intercure request (general practitioner: 27.6% and oncologist: 60.5%) than for the real performed medical request (general practitioner: 34.2% and oncologist: 46%). The study showed that the general practitioner was even more considered as the primary care request doctor during intercure when he was invested as a diagnosis actor. The study did not show up any choice competitivity between the oncologist and the general practitioner in patients representation, which is coherent with the hierarchical organization of the current health care system. Conclusion: The generalization of these conclusions would need a study based on a wider and more representative sample of breast cancer affected patients, integrating all the social classes and the rural areas. [ABSTRACT FROM AUTHOR]

Summary: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neurostimulation tool with increasing therapeutic applications in neurology, psychiatry and in the treatment of chronic tinnitus, and with a growing interest in cognitive neuroscience. One of its side effects is the loud click sound generated simultaneously to the magnetic pulse, which depends both on the equipment and rTMS intensity. This impulse sound could transiently modify peripheral hearing mechanisms, and hence hearing thresholds, both in patients and in rTMS practitioners. Furthermore, if no precautions are taken, especially in subjects with several risks factors for hearing loss, it is possible that the repetition of exposure could lead to more definitive changes in hearing thresholds. These issues are often neglected, although they could have specific relevance in rTMS treatment for tinnitus or in auditory cognitive neuroscience. This review specifically deals with noise exposure during rTMS and its potential consequences on the auditory system. It provides several practical solutions to help minimize exposure. [Copyright &y& Elsevier]

Summary: Antipsychotics are commonly prescribed in France and Europe in the field of child and adolescent psychiatry. However, most of the prescriptions are outside reglementary rules (AMM or PUMA). Second Generation AntiPsychotics (SGAP) have show their efficacy in many psychiatric diseases, especially in schizophrenia spectrum disorders, bipolar disorders or behaviour disorders in autism and intellectual deficiency patients. However, recent data suggest that child and adolescent population patients may have a different tolerance profile when compared with adults. This last point leads to a better assessment of the benefice/risk ratio in this population when using SGAP. It is important to notice that there are still few studies in the field of child and adolescent psychiatry, especially regarding behaviour disorder associated with autism spectrum disorders or intellectual deficiency. Authors of this article present a review of the literature regarding efficacy and tolerance of SGAP and call for further studies in this specific population, particularly in the basement of side effects. Moreover, randomized controlled studies comparing SGAP and first generation AP are needed as better tolerance is considered to be the key argument in the actual consensus of SGAP first choice in treatment. [Copyright &y& Elsevier]

Abstract: The article reviews the ophthalmologic side effects of systemic corticosteroids. These side effects include involvement of both anterior (cataract, ocular hypertension) and posterior (serous central chorioretinopathy) segements of the eye. We review the clinical presentations and detail the advance in the knowledge still incomplete of the pathophysiological mechanisms involved in the occurrence of these complications. The clinical knowledge of the ophthalmologic side effects of systemic corticosteroids is essential to inform our patients, and prevent or detect these complications to treat them appropriately. [Copyright &y& Elsevier]

Abstract: Objective: Perioperative gabapentine administration improves analgesia, reduces postoperative nausea and vomiting, but increases sedation. Pregabalin is also a gabapentinoid, with an improved bioavailability. This systematic review evaluates the analgesic effect and tolerance of perioperative pregabaline. Study design: Systematic review. Methods: Systematic search in Pubmed database of clinical human randomized controlled studies dealing with perioperative administration of pregabalin. A quantitative review of pregabalin efficiency and an analysis of the main side effects reported in these studies was then performed. Results: Twenty-three study arms (884 patients) received at least one dose of pregabalin in 17 studies (totalizing 1577 patients). Pregabalin improved analgesia in 11 of 23 study arms. Pregabalin improved analgesia in three of 12 study arms after ambulatory surgery, and in eight of 11 after major surgery (P =0.04). Two of three studies about chronic postoperative pain revealed improved results in pregabalin groups. Nevertheless, pregabalin did not reduce postoperative nausea/vomiting, pruritus and headache, but increased trouble with vision, drowsiness, severe sedation and dizziness during the first postoperative hours, without severe clinical consequence. Severe sedation seemed clearly dose dependant, while drowsiness, dizziness or visual disturbance did not. Conclusion: A favorable benefit risk-ratio is demonstrated only for major surgery (excluding ambulatory surgery). The lack of data concerning tolerance of pregabalin in the elderly and/or in case of renal dysfunction forbids any conclusion in these populations. [Copyright &y& Elsevier]