Difficulties associated with outpatient management of drug abusers by general practitioners. A cross-sectional survey of general practitioners with and without methadone patients in Switzerland

BACKGROUND: In Switzerland, general practitioners (GPs) manage most of the patients receiving methadone maintenance treatment (MMT). METHODS: Using a cross-sectional postal survey of GPs who treat MMT patients and GPs who do not, we studied the difficulties encountered in the out-patient management of drug-addicted patients. We sent a questionnaire to every GP with MMT patients (556) in the French-speaking part of Switzerland (1,757,000 inhabitants). We sent another shorter questionnaire to primary care physicians without MMT patients living in the Swiss Canton of Vaud. RESULTS: The response rate was 63.3%. The highest methadone dose given by GPs to MMT patients averaged 120.4 mg/day. When asked about help they would like to be given, GPs with MMT patients primarily mentioned the importance of receiving adequate fees for the care they provide. Secondly, they mentioned the importance of better training, better knowledge of psychiatric pathologies, and discussion groups on practical cases. GPs without MMT patients refuse to treat these patients mostly for emotional and relational reasons. CONCLUSION: GPs encounter financial, relational and emotional difficulties with MMT patients. They desire better fees for services and better training

Finger creases lend a hand in Kabuki syndrome.

International audienceKabuki syndrome (KS) is a rare syndrome associating malformations with intellectual deficiency and numerous visceral, orthopedic, endocrinological, immune and autoimmune complications. The early establishment of a diagnostic of KS leads to better care of the patients and therefore prevents complications such as perception deafness, severe complications of auto-immune diseases or obesity. However, the diagnosis of KS remains difficult because based on the appreciation of facial features combined with other highly variable features. We describe a novel sign, namely the attenuation and/or congenital absence of the IPD crease of the third and fourth fingers associated with limitation of flexion of the corresponding joints, which seems to be specific of KS and could help the clinician to diagnose KS

Réalisation technologique de capteurs d'humidité - Application à l'industrie automobile

National audienc

Dépendances: nouveautés en médecine 2008 [Addiction]

L'actualité 2008 des dépendances est centrée sur l'avancée des neurosciences psychiatriques dans le domaine des addictions mais aussi sur les clarifications nécessaires face à la complexité des comorbidités psychiatriques des addictions, notamment en cas de schizophrénie. Enfin, le praticien trouvera des considérations utiles pour la prescription de traitements de substitution chez des patients VIH en trithérapie. The highlights 2008 in the addiction field are correlated to the progress of psychiatric neurosciences. Clarifications are also necessary towards the psychiatric comorbidities (schizophrenia) with the addictions. Then, useful considerations are given for the prescription of substitution treatment among HIV patients under tritherapy

Wine and website loyalty: A model of sales promotion and service attributes

Purpose - This paper examines the relationship between feelings toward buying wine onmobile phones and m-commerce website loyalty by examining a) the mediating role of salespromotion and b) the moderating role of service attributes of the m-commerce websites.Design/methodology/approach - The study comprised a questionnaire among 2754 responsesfrom six countries (France, Germany, Greece, South Africa, United States and Canada). Non-probability criterion-based purposive sampling was used, screening for legal drinking age andownership of a smartphone.Findings - Results show that sales promotion mediates the relationship between feelingstowards buying wine on mobile phones and m-commerce website loyaltyPractical implications - Wine producers and retailers should consider the use of salespromotion to enhance sales and loyalty to m-commerce websites</p

Methadone maintenance treatment (MMT) in general practice or in specialized centers: profile of patients in the Swiss Canton of Vaud.

We studied profile of patients (n=1782) treated in specialized centers and general practice (GP) enrolled in methadone maintenance treatment (MMT) programs during 2001 in the Swiss Canton of Vaud. We found that GPs treated the majority of patients (76%). Specialized centers treated a higher proportion of patients with uncontrolled intravenous use of cocaine and heroin, and prescribed neuroleptics as concomitant medication three times more frequently than GPs. Patients treated in specialized centers were more likely to undergo screening for HIV, HBV, HCV, and receive complete HBV immunization. In conclusion, specialized centers are more likely to treat severely addicted patients and patients with a poor global assessment (physical, psychiatric, and social)

Discussion du projet de décret contenu dans le rapport de Lindet, au nom des trois comités de Commerce, de Législation et de Salut public, sur un nouveau mode de fixer le maximum des grains, lors de la séance du 14 brumaire an III (4 novembre 1794)

Maure Nicolas-Sylvestre, Tallien Jean-Lambert, Beffroy de Beauvoir Louis Etienne, Gaston Raymond, Legendre (de la Nièvre) François-Paul, Cambon Pierre-Joseph, Pénières, Thibault Anne-Alexandre-Marie, Coupé (de l'Oise) Jacques-Michel, Réal André, Pelet Jean. Discussion du projet de décret contenu dans le rapport de Lindet, au nom des trois comités de Commerce, de Législation et de Salut public, sur un nouveau mode de fixer le maximum des grains, lors de la séance du 14 brumaire an III (4 novembre 1794). In: Archives Parlementaires de 1787 à 1860 - Première série (1787-1799) Tome C - Du 3 au 18 brumaire an III (24 octobre au 8 novembre 1794) Paris : CNRS éditions, 2000. pp. 400-404

Studies on Transport of Chemical Constituents in Germinating Plant Seeds (I) : Transport of nitrogenous constituents in germinating soybean seeds

textabstractHirschsprung disease (HSCR) genetics is a paradigm for the study and understanding of multigenic disorders. Association between Down syndrome and HSCR suggests that genetic factors that predispose to HSCR map to chromosome 21. To identify these additional factors, we performed a dose-dependent association study on chromosome 21 in Down syndrome patients with HSCR. Assessing 10,895 SNPs in 26 Caucasian cases and their parents led to identify two associated SNPs (rs2837770 and rs8134673) at chromosome-wide level. Those SNPs, which were located in intron 3 of the DSCAM gene within a 19 kb-linkage disequilibrium block region were in complete association and are consistent with DSCAM expression during enteric nervous system development. We replicated the association of HSCR with this region in an independent sample of 220 non-syndromic HSCR Caucasian patients and their parents. At last, we provide the functional rationale to the involvement of DSCAM by network analysis and assessment of SOX10 regulation. Our results reveal the involvement of DSCAM as a HSCR susceptibility locus, both in Down syndrome and HSCR isolated cases. This study further ascertains the chromosome-scan dose-dependent methodology used herein as a mean to map the genetic bases of other sub-phenotypes both in Down syndrome and other aneuploidies

Discussion du projet de décret contenu dans le rapport de Lindet, au nom des trois comités de Commerce, de Législation et de Salut public, sur un nouveau mode de fixer le maximum des grains, lors de la séance du 14 brumaire an III (4 novembre 1794)

Maure Nicolas-Sylvestre, Tallien Jean-Lambert, Beffroy de Beauvoir Louis Etienne, Gaston Raymond, Legendre (de la Nièvre) François-Paul, Cambon Pierre-Joseph, Pénières, Thibault Anne-Alexandre-Marie, Coupé (de l'Oise) Jacques-Michel, Réal André, Pelet Jean. Discussion du projet de décret contenu dans le rapport de Lindet, au nom des trois comités de Commerce, de Législation et de Salut public, sur un nouveau mode de fixer le maximum des grains, lors de la séance du 14 brumaire an III (4 novembre 1794). In: Archives Parlementaires de 1787 à 1860 - Première série (1787-1799) Tome C - Du 3 au 18 brumaire an III (24 octobre au 8 novembre 1794) Paris : CNRS éditions, 2000. pp. 400-404