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Summary Aim of the study Health-related networks like patient health forums may be considered as potential sources of information to early detect pharmacovigilance issues or complete data on drug safety. However, the clinical and pharmacological relevancy of such a source has not been clearly explored. We aimed to describe the characteristics and the informativeness level of Internet narratives posted by patients and mentioning adverse drug reactions (ADRs) related to statins. Methods A retrospective cross-sectional study was conducted on an Internet website dedicated to share experience on medicines. One day of December 2012, postings about simvastatin, rosuvastatin and atorvastatin publicly available on the website were collected. Their informativeness according to 16 key elements of information (including drug start and stop date, duration of treatment, time to onset and duration of the ADR, outcome, medical history, concomitant medication) was assessed. General information about reported ADRs was also investigated. Results Among the 96 postings related to statins, 72 (40 women, 32 men; mean age: 59 [40–78]) mentioned at least one ADR accounting for a total of 176 ADRs. Musculoskeletal and connective tissue disorders (42.6%) and nervous system disorders (15.3%) were the main represented ADRs. Only 2 patients mentioned ADRs that could be considered as serious but 24 patients mentioned they stopped or switched their treatment toward another lipid modifying agent because of the ADR. Mean number of available key elements of information per narrative was 6/16. Time to onset and duration of the ADR were respectively available in only 31% and 3% of the narratives. Medical history and concomitant medication were respectively lacking in 87% and 86% of the narratives. Outcome was found only in 39% of the narratives. Conclusion Patient narratives posted on Internet include mainly non-serious expected ADR. However, their informativeness level is very incomplete and makes difficult their assessment and use for pharmacovigilance purpose.

Resume Introduction Le tramadol est un antalgique opioide faible indique dans le traitement des douleurs moderees a intenses de l’adulte. Les effets indesirables les plus frequents du tramadol sont gastro-intestinaux et neurologiques. L’hypoglycemie est un effet indesirable peu connu, et peu publie jusqu’a present. Observations Nous rapportons deux observations d’hypoglycemie survenue suite a l’instauration d’un traitement par tramadol par voie orale, chez des patients non diabetiques. Les mecanismes de l’hypoglycemie au tramadol sont mal compris. Dans la litterature, on retrouve quelques observations d’hypoglycemie avec le dextropropoxyphene, un autre opioide faible. Suite au retrait du marche de cette molecule, on peut s’attendre a une progression de la prescription de tramadol et les professionnels de sante doivent etre avertis du risque potentiel d’hypoglycemie. Conclusion Le risque d’hypoglycemie devrait figurer dans le resume des caracteristiques du produit du tramadol.

Summary The uptake and distribution of intramuscularly (IM) administered tritium-labeled polysulfated glycosaminoglycan ( 3 H-PSGAG) in serum, synovial fluid, and articular cartilage of eight horses was quantitated, and hyaluronic acid (HA) concentration of the middle carpal joint was evaluated in a pharmacokinetic study. A full-thickness articular cartilage defect, created on the distal articular surface of the left radial carpal bone of each horse served as an osteochondral defect model. 3 H-PSGAG (500 mg) was injected IM, between 14 and 35 days after creation of the defects. Scintillation analysis of serum and synovial fluid, collected from both middle carpal joints at specific predetermined times up to 96 hours post-injection, revealed mean 3 H-PSGAG concentrations peaked at 2 hours post-injection. 3 H-PSGAG was detected in cartilage and subchondral bone 96 hours post-injection in samples from all eight horses. There were no statistically significant differences in 3 H-PSGAG concentration of synovial fluid or cartilage between cartilage defect and control (right middle carpal) joints. HA assay of synovial fluid revealed concentrations significantly increased at 24, 48, and 96 hours post-injection in both joints. The concentration nearly doubled 48 hours post-injection. However, no statistically significant differences were found between synovial concentrations of HA in cartilage defect and control joints. 3 H-PSGAG administered IM to horses, was distributed in the blood, synovial fluid, and articular cartilage. HA concentrations in synovial fluid increased after IM administration of polysulfated glycosaminoglycan.