Issues around the prescription of half tablets in northern Switzerland: the irrational case of quetiapine

Background. Prescription of fragmented tablets is useful for individualisation of dose but includes several drawbacks. Although without score lines, the antipsychotic drug quetiapine was in 2011 the most often prescribed 1/2 tablet in discharge prescriptions at the University Hospital in Basel (USB, 671 beds). We aimed at analysing the prescription patterns of split tablets in general and of quetiapine in particular in Switzerland. Methods. All orders of community pharmacies for unit-of-use soft pouch blisters placed at Medifilm AG, the leader company in Switzerland for repackaging into pouch blisters, were analysed. Results. Out of 4,784,999 tablets that were repacked in 2012 in unit-of-use pouch blisters, 8.5% were fragmented, mostly in half (87.6%), and were predominantly psycholeptics (pipamperone 15.8%). Prescription of half quetiapine appears to be a Basel specificity (highest rates of fragments and half quetiapine). Conclusions. Prescription of fragmented tablet is frequent. It represents a safety issue for the patient, and a pharmaceutical care issue for the pharmacist. In ambulatory care, the patient's cognitive and physical capacities must be clarified, suitability of the splitting of the tablet must be checked, appropriate aids must be offered, like a pill-splitting device in order to improve accuracy, and safe use of the drug must be ensured

"Quand un zima rencontre un marabout": Analyse de trois récits de jasare ayant pour objet le face-à-face de l'islam et des religions du terroir (Niger).

National audienc

Jouer avec le genre dans les arts de la parole

Spectacle de femmes herboristes au marché de Beni Mellal, rituel féminin bouffon au Mali, chansons composées par les Azriat d'Algérie, performance théâtrale de patientes de l'hôpital psychiatrique, controverses et rap sur le net, autant de lieux, de moments et de contextes où les identités de genre apparaissent, se négocient, se transforment et s'incarnent. En continuité épistémologique avec les premiers travaux des anthropologues sur les rapports sociaux de sexe, ce numéro intitulé "Jouer avec le genre dans les arts de la parole" propose une approche des pratiques d'hybridation et de transformations des rôles et des hiérarchisations grâce à l'apport récent des travaux en étude de genre (gender). En mettant au jour les multiples façons qu'ont différents groupes sociaux de jouer avec les normes et les identités, l'ensemble des contributions démontre toute l'importance d'analyser les performances orales selon l'approche interdisciplinaire et intersectionnelle que permet l'outil du genre

Besoins en données sur les sols en liaison avec les problèmes d'agriculture et d'environnement

National audienc

The risk of new onset depression in association with influenza - a population-based observational study

Case-reports provided evidence that influenza infections, particularly severe episodes, may exert neuronal damage in the CNS and thereby increase the risk of depression.; It was the aim of this study to analyse the association between influenza infections and the risk of developing incident depression.; We conducted a case-control analysis between 2000 and 2013 using the large UK-based primary care database Clinical Practice Research Datalink (CPRD).; This database contains anonymous longitudinal data from primary care. At present, it contains over 100million person-years of data from some 10million active patients.; We encompassed 103307 patients below the age of 80years with an incident major depression diagnosis between 2000 and 2013, and matched each case to one control patient on age, sex, general practice, number of medical encounters, and years of history in the CPRD prior to the index date.; Major depression diagnosis was identified by READ-codes based on ICD-10 codes (F32), with a minimum of three prescriptions for antidepressant drugs recorded after the diagnosis.; We calculated relative risk estimates of developing depression in association with previous influenza infections, stratified by the number, timing and severity of such events, and we adjusted for a variety of comorbidities, smoking status, alcohol intake, body mass index, use of oral corticosteroids, and benzodiazepines.; Patients with a previous influenza infection had an increased risk of developing depression (OR 1.30, 95%CI 1.25-1.34) compared to patients with no history of influenza infections. A recent influenza infection recorded within 30-180days prior to the index date yielded an adjusted 1.57 (95%CI 1.36-1.81), and an increasing number of previous influenza infections was associated with increasing odds ratios (⩾3 recorded influenza infections, adjusted OR 1.48, 95%CI 1.22-1.81).; This study suggests that influenza infections are associated with a moderately increased risk of developing depression

Impact of positive legionella urinary antigen test on patient management and improvement of antibiotic use

Aim: To assess the incidence of legionella infection over a 27 month period at a large university hospital. Material and Methods: The present retrospective cohort study enrolled patients with legionellosis, defined as those presenting a positive urinary antigen for legionella together with a medical history, clinical findings, and radiological findings consistent with pneumonia. These patients were evaluated to determine the relation between their test results and changes in treatment modalities. A control group of patients with pneumonia but a negative urinary antigen test for legionella were also analysed. Results: Twenty seven of 792 assessed patients tested positive for legionella. In 22 of these patients, legionella active antibiotics were administered empirically. In seven patients, the test results prompted a legionella specific treatment, whereas in 12 cases, non-specific antibiotics were stopped within 24 hours. Overall, treatment was altered in more than half of the patients as a result of the test results. Conclusions: The urinary antigen may have a direct impact on clinical management of pulmonary legionellosis. However, patient comorbidities and individual clinical judgment are still important for determining the best treatment to be given in each individual case