Psychopathology particularities patient ' s HIV / AIDS

Catedra Psihiatrie, Narcologie şi Psihologie medicală USMF „Nicolae Testemiţanu”The aim was to analyze patients with psychiatric disorders caused by HIV / AIDS. Psychiatric disorders among people with HIV have been identified in an early stage of the disease through a variety of psychiatric disorders, directly or indirectly associated with HIV: affective disorders, acute psychotic disorders, cognitive disorders, anxiety, adjustment disorders, delirium, HIV-associated dementia. Scopul lucrării a constat în analiza pacienţilor cu tulburări psihice, determinate de HIV/SIDA. Tulburările psihice în rândul persoanelor cu HIV au fost identificate într-un stadiul precoce al bolii printr-o gamă largă de tulburări psihice, direct sau indirect, asociate cu HIV: dereglări afective, tulburări psihotice acute, dereglări cognitive, anxietate, tulburări de adaptare, delirium, demenţă HIV-asociată

Stable One-Dimensional Periodic Wave in Kerr-Type and Quadratic Nonlinear Media

We present the propagation of optical beams and the properties of one-dimensional (1D) spatial solitons (“bright” and “dark”) in saturated Kerr-type and quadratic nonlinear media. Special attention is paid to the recent advances of the theory of soliton stability. We show that the stabilization of bright periodic waves occurs above a certain threshold power level and the dark periodic waves can be destabilized by the saturation of the nonlinear response, while the dark quadratic waves turn out to be metastable in the broad range of material parameters. The propagation of (1+1) a dimension-optical field on saturated Kerr media using nonlinear Schrödinger equations is described. A model for the envelope one-dimensional evolution equation is built up using the Laplace transform

Spontaneous Reports of Serious Adverse Drug Reactions Resulting From Drug–Drug Interactions: An Analysis From the French Pharmacovigilance Database

International audienceFew data are available on the clinical impact of drug–drug interactions (DDIs). Most of the studies are limited to the analysis of exposure to potential DDI or the targeted impact of the combination of a few drugs or therapeutic classes. The analysis of adverse drug reaction (ADR) reports could be a mean to study generally the adverse effects identified due to a DDI. Our objective was to describe the characteristics of ADRs resulting from DDIs reported to the French Pharmacovigilance system and to identify the drugs most often implicated in these ADRs. Considering all ADR reports from January 01, 2012, to December 31, 2016, we identified all cases of ADR resulting from a DDI (DDI-ADRs). We then described these in terms of patients’ characteristics, ADR seriousness, drugs involved (two or more per case), and ADR type. Of the 4,027 reports relating to DDI-ADRs, 3,303 were related to serious ADRs. Patients with serious DDI-ADRs had a median age of 76 years (interquartile range: 63–84); 53% were male. Of all serious DDI-ADRs, 11% were life-threatening and 8% fatal. In 36% of cases, the DDI causing the ADR involved at least three drugs. Overall, 8,424 different drugs were mentioned in the 3,303 serious DDI-ADRs considered. Altogether, drugs from the “antithrombotic agents” subgroup were incriminated in 34% of serious DDI-ADRs. Antidepressants were the second most represented therapeutic/pharmacological subgroup (5% of serious DDI-ADRs). Among the 3,843 ADR types reported in the 3,303 serious DDI-ADRs considered, the most frequently represented were hemorrhage (40% clinical hemorrhage; 6% biological hemorrhage), renal failure (8%), pharmacokinetic alteration (5%), and cardiac arrhythmias (4%). Hemorrhagic accidents are still an important part of serious ADRs resulting from DDIs reported in France. The other clinical consequences of DDIs seem less well identified by pharmacovigilance. Moreover, more than one-third of serious DDI-ADRs involved at least three drugs

Adverse Drug Reaction-Related to Drug Shortage: A Retrospective Study on the French National Pharmacovigilance Database

International audienceAIM: Drug shortage is a growing global health issue. The aim of the study was to evaluate the consequences of drug shortages on patient safety based on data recorded in the French Pharmacovigilance Database. METHODS: All cases involving drug shortages reported from 1985 to the end of 2019 were extracted from the database. RESULTS: Following the selection process, 462 cases were included. The number of cases increased significantly from 2004 to 2019. Cases mainly involved drugs from the nervous system (22.1%, CI95[17.5;27.0]), the cardiovascular system (16.4%, CI95[11.9;21.4]), and anti-infectives for systemic use (14.3%, CI95[9.7;19.2]) ATC classes. Most of the cases reported an adverse drug reaction (ADR) belonging to the SOC nervous system (21%, CI95[18;24]), skin and subcutaneous (14%, CI95[11;17]), general (13%, CI95[10;17]), and gastrointestinal (8%, CI95[5;11]) disorders. Disease worsening was observed in 15.9% of the cases, mostly related to a lack of efficacy of the replacement drug. Half of the cases were considered as serious. Evolution was favourable in 79.4% of the cases. Death and/or life-threatening situations were reported in 5.8% of the cases. Medication errors (ME) were identified in 51 cases (11%), mostly occurring at the administration step and involving a human factor. CONCLUSION: This study emphasises the clinical impact of drug shortage in terms of ADRs, ME and inefficiency. These observations underline the importance of a global health policy programme to limit the occurrence of drug shortages and to reinforce the information provided to patients and health care professionals in this context to limit risk

Global impact of tropical cyclones on primary production

International audienceIn this paper, we explore the global responses of surface temperature, chlorophyll, and primary production to tropical cyclones (TCs). Those ocean responses are first characterized from the statistical analysis of satellite data under ~1000 TCs over the 1998–2007 period. Besides the cold wake, the vast majority of TCs induce a weak chlorophyll response, with only ~10% of induced blooms exceeding 0.1 mg m. The largest chlorophyll responses mostly occur within coastal regions, in contrast to the strongest cold wakes that generally occur farther offshore. To understand this decoupling, we analyze a coupled dynamical-biogeochemical oceanic simulation forced by realistic wind vortices applied along observed TC tracks. The simulation displays a realistic spatial structure of TC-induced blooms and its observed decoupling with TC cold wakes. In regions of strong TC energy input, the strongest cold wakes occur in regions of shallow thermocline (<60 m) and the strongest blooms in regions of shallow nitracline and/or subsurface chlorophyll maximum (<60 m). Shallow thermoclines are found over many open ocean regions, while regions of shallow nitracline and/or subsurface chlorophyll maximum are most prominent in near-coastal areas, explaining the spatial decoupling between the cold and bloom wakes. The overall TC contribution to annual primary production is weak and amounts to ~1%, except in a few limited areas (east Eurasian coast, South tropical Indian Ocean, Northern Australian coast, and Eastern Pacific Ocean in the TC-prone region) where it can locally reach up to 20–30%. Nearly 80% of this TC-induced annual primary production is the result of the biogeochemical response to the 30% strongest TCs

Liquid formulation of ifosfamide increased risk of encephalopathy: A case-control study in a pediatric population

International audienceBACKGROUND:Several clusters of encephalopathy occurred after the market change from Holoxan® (ifosfamide lyophilized powder) to Ifosfamide EG® (liquid formulation) and justified a formal survey in 2015. In June 2016, the regulatory authority decided to apply a precautionary measure in reducing the shelf life of Ifosfamide EG® at 7 months. One-year study from spontaneous reports lead to suspect a potential residual risk. Due to the many limitations associated with spontaneous notifications, we performed a multicentric observational study, aiming to better explore this pharmacovigilance signal.METHODS:We performed a case-control study in pediatric oncology Departments of 25 university hospitals between July 1st, 2016 and July 1st, 2018. All children (<18 y.o.) receiving liquid formulation or lyophilized powder formulation during the study period were included. Patients with at least one occurrence of encephalopathy were considered as cases. Logistic regression model was used to estimate the odds ratio of encephalopathy between exposure groups.RESULTS:During the study period, 52 cases and 495 controls were included. A residual over-risk of encephalopathy was associated with ifosfamide 7-month shelf-life liquid formulation compared to lyophilized powder (adjusted OR 1.91, 95% CI: 1.03-3.53).CONCLUSIONS:Observed difference does not seem to be related to the pathology treated, the doses used, the co-medications, a meningeal localization and/or an irradiation of the central nervous system. This study confirms data from spontaneous reports that led to the precautionary measure for the liquid formulation. Even if the risk of encephalopathy seems reduced, our study suggests the persistence of a residual risk of encephalopathy associated with liquid formulation compared to the lyophilized powder