18 research outputs found

    Fundam Clin Pharmacol

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    BACKGROUND: Due to its psychoactive effects, ketamine has become a drug used for non-medical purpose. OBJECTIVES: To assess the latest trends in ketamine use among people with substance use disorder and to characterize its clinical complications using complementary health data sources of the French Addictovigilance Network. METHODS: First, we extracted all reports involving ketamine from 2012 to 2021 from the database of the OPPIDUM program (i.e., a multicentric program conducted in collaboration with hundreds of substance abuse treatment facilities that collects data on drugs used by subjects with substance use disorders). We described the reports globally and the changes from 2012 to 2021. Second, we extracted all cases involving ketamine from July 2020 to December 2022 from the French National Pharmacovigilance Database (BNPV). We identified the cases related to ketamine use among people with substance use disorder and described them. RESULTS: There was a 2.5-fold increase in the number of ketamine users with substance use disorder in the OPPIDUM program, from 35 (0.7%) subjects in 2012 to 89 (1.7%) subjects in 2021. There was an increase in the proportion of subjects who were daily users, had distress upon discontinuation, and presented addiction. There were 238 cases related to ketamine use among people with substance use disorder in the French National Pharmacovigilance Database from July 2020 to December 2022. Among them, 94 (39.5%) cases involved ketamine use disorder, 20 (8.4%) cases involved urinary tract and kidney symptoms, and 13 (5.5%) cases involved hepatobiliary symptoms. CONCLUSION: The trend observed over 10 years reflects the growth in ketamine use among people with substance use disorder, although it does not allow to estimate the rates of non-medical use of ketamine in the general population. Ketamine-induced uropathy and cholangiopathy are reported in ketamine users with substance use disorder, especially in case of repeated and/or prolonged use of high doses

    Methanol plasma treatment of fluorocarbon ultra-thin films for stents applications

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    The surgical implantation of metallic stents in a narrowed vessel after balloon angioplasty is a common procedure to prevent restenosis phenomena, but the related complications, such as thrombosis, inflammation and devices corrosion, are still a serious concern. In order to limit those complications, the coating of metallic stents, by Plasma Enhanced Chemical Vapor Deposition (PECVD), with Fluorocarbon (CFx) ultrathin films has been demonstrated to be an interesting strategy, thanks to the CFx biocompatibility, chemical inertness, impermeability, corrosion resistance, appropriate mechanical properties and high adhesion to the substrates[1],[2]. Nevertheless, the modification of some key surface properties of CFx coatings could further improve their blood compatibility. For example, it has been shown that the presence of carboxyl groups and a moderate surface wettability could promote the appropriate proteins adhesion, improving the hemocompatibility and promoting the surface endothelialisation[3],[4]. The objective of this work was to develop an oxidation process of CFx coatings, based on a methanol plasma treatment. The modification of the surface oxygen content and wettability was aimed to modulatie protein adsorption and blood compatibility of CFx films, without affecting their excellent mechanical and corrosion resistance properties

    Assessment of terrestrial carbon stocks from regional to agricultural landscapes using SMAP-L4 Carbon Net Ecosystem Exchange dataset: review and application (Maradi, Republic of Niger)

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    International audienceContinental carbon (C) sequestration plays a major role in climate change resilience, mitigation, and agro-ecological intensification. Soil Moisture Active Passive Global Daily Carbon Net Ecosystem Exchange dataset (SMAP L4) is used for monitoring daily terrestrial C stocks, given the high potential of semiarid areas for Sustainable Goals achievements, in terms of human issues and surface areas. Inter-and intra-annual variation of Global Primary Productivity (GPP), Net Ecosystem CO2 Exchange (NEE), Soil Heterotrophic Respiration (RH) and Soil Organic Carbon (SOC) were analyzed from 2015 to 2020, across the region of Maradi (Niger) and 15 sites with rainfed crops and vegetal mosaics. To quantify temporal trends of C indicators across years, Mann-Kendall were conducted based on yearly GPP days of min/max. It underlined declines of SOC in the northern part of Maradi (τ >-0.6), rising in the south (τ > +0.6). Univariate monitoring (e.g. 2162 daily measurements) of GPP and RH showed asymmetries in their distribution (positive skews, GPP ̅ =1.19 gC m-2 d-1 , Me=0.88 gC m-2 d-1 ; RH ̅ =0.679 gC m-2 d-1 ; Me=0.485 gC m-2 d-1). This result might be attributed to local variations of Plant Functional Types and microbial activities. Averaged NEE stressed a slightly negative C balance among sites (overall ̅ =-0.003 gC m-2 d-1), suggesting their storage capacity. Processing aspects being set up, a consolidation of those first results should be done. Satellite data records analysis argue for the implementation of Man-Environment observatories in Maradi as a pilot region, for both remote and local understanding of C behavior in agroecosystems and multiscale counseling

    Exposure to ammonia solution due to substance use: a retrospective study from the French poison centres database (2009–2018)

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    Ammonia solution (ammonium hydroxide) is used to convert cocaine hydrochloride to freebase cocaine. Due to its causticity, unintentional exposure to ammonia in a substance use context can result in injury. The objective of this study was to describe the characteristics of unintentional oral and buccal ammonia solution exposure in a substance use context. A retrospective study was conducted using the French poison centres database over a 10-year period (2009–2018). A total of 1,546 files were extracted, and 263 substance users were included. There was a significant increase in the number of these exposures between 2009 and 2018. Unintentional ingestion of ammonia solution was linked to product decanting in 89 per cent of cases. Substance use prior to the exposure and a festive context, such as free parties or teknivals, were identified in 25 per cent and 21 per cent of cases, respectively. Patients received a hospital examination in 87 per cent of cases. The severity of intoxication in substance users was graded as moderate (33 per cent) or severe (15 per cent) using the Poisoning Severity Score. The increased number of ammonia solution cases reported was consistent with an increase in the number of crack users in Europe in the same period. Ammonia solution exposure can suggest the possibility of substance use disorders. In such cases, patients can be referred to receive appropriate treatment and support. This study had some limitations, such as the lack of available information due to the retrospective nature of the study and the non-standardized questions asked by the poison centre during the medical phone interviews. Oral and buccal ammonia solution exposure in known substance users in France increased between 2009 and 2018. These users were mostly young men. A festive context and decanting were frequent. Patients were mainly referred to emergency departments to receive clinical examination and care. The potential severity of oral or buccal ammonia solution exposure in substance users requires increased vigilance among all healthcare professionals involved in the management of these intoxication cases.</p

    Produits du tabac, produits connexes et arĂŽmes - Analyse des cas enregistrĂ©s par les centres antipoison (de janvier 2017 Ă  dĂ©cembre 2022): Rapport d’étude de toxicovigilance

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    Citation suggĂ©rĂ©e : Anses. 2023. Produits du tabac, produits connexes et arĂŽmes. Bilan des cas rapportĂ©s aux centres antipoison du 1er janvier 2017 au 31 dĂ©cembre 2022. Autosaisine 2023-AUTO-0121. Anses, Maisons-Alfort, 37 p.Le marchĂ© des produits du tabac, des produits connexes (ne contenant pas de tabac mais de la nicotine), et des arĂŽmes pour les parfumer ne cesse de se diversifier. Parmi eux, cinq types font l’objet d’appels aux Centres antipoison (CAP) mais Ă  ce jour, aucun bilan n’en avait Ă©tĂ© dressĂ©. Il s’agit du tabac Ă  chauffer (bĂątonnets de tabac chauffĂ©s), du tabac Ă  mĂącher (encore appelĂ© tabac Ă  chiquer), du snus (sachets de tabac Ă  usage oral, Ă  placer entre la lĂšvre et la gencive), plus rĂ©cemment des sachets de nicotine (sans tabac Ă  usage oral, Ă  placer Ă©galement entre la lĂšvre et la gencive),et des billes aromatiques (Ă  insĂ©rer dans le filtre de cigarettes).Le bilan de ces appels aux CAP entre le 1 er janvier 2017 et le 31 dĂ©cembre 2022 a recensĂ© 295 cas : 12 cas pour le tabac Ă  chauffer, 98 pour le tabac Ă  mĂącher, 47 pour le snus et sachets de nicotine et 138 cas pour les billes aromatiques. Hormis pour le tabac Ă  chauffer et Ă  mĂącher dont le nombre d’appels Ă©voluait peu dans le temps, le nombre de cas n’a cessĂ© d’augmenter depuis 2020 pour le snus, les sachets de nicotine et les billes aromatiques. L’étude a montrĂ© que les jeunes enfants Ă©taient les plus concernĂ©s par des ingestions accidentelles de bĂątonnets de tabac Ă  chauffer et detabac Ă  mĂącher (Ăąge mĂ©dian : 1 an) ou de billes aromatiques (Ăąge mĂ©dian : 3 ans). Les adolescents Ă©taient davantage concernĂ©s par une consommation intentionnelle de snus ou de sachets de nicotine (Ăąge mĂ©dian : 14 ans). Les adultes Ă©taient plus rarement concernĂ©s par de ces deux types de produits ou par l’ingestion accidentelle de billes aromatiques au moment de leur utilisation dans des cigarettes. Dans 54,6 % des cas, les personnes prĂ©sentaient des symptĂŽmes dont 82,6% Ă©taient de gravitĂ© faible. Les cas de gravitĂ© moyenne correspondaient Ă  un syndrome nicotinique plus sĂ©vĂšre(vomissements prolongĂ©s avec risque de dĂ©shydratation, convulsions, troubles de la conscience, hypotension ayant nĂ©cessitĂ© un remplissage vasculaire), chez des enfants ayant ingĂ©rĂ© accidentellement du tabac Ă  chauffer (un enfant d’un an) et du tabac Ă  mĂącher (15 enfants de 6 mois Ă  7 ans), et chez dix adolescents ayant consommĂ© du snus ou des sachets de nicotine dont huit d’entre eux en milieu scolaire. Concernant les billes aromatiques, aprĂšs ingestion, un enfant de 3 ans avait prĂ©sentĂ© des symptĂŽmes de gravitĂ© moyenne (vomissements persistants). Quatorze cas correspondaient Ă  des projections oculaires de gravitĂ© faible Ă  l’origine de douleurs et de rougeurs oculaires.Le nombre des cas est probablement sous-estimĂ©. Une attention particuliĂšre doit ĂȘtre portĂ©e aux sachets de nicotine qui n’entrent pas dans un cadre rĂšglementaire spĂ©cifique en France, ni mĂȘme harmonisĂ© en Europe. Ces produits, par leurprĂ©sentation, peuvent ĂȘtre confondus avec du snus. La vente de ces deux types de produits est fortement promue sur les rĂ©seaux sociaux et s’adresse Ă  une population jeune, sous-estimant les risques d’intoxication aiguĂ« ou Ă  moyen et long terme, de dĂ©pendance. Il est important de sensibiliser la communautĂ© Ă©ducative, les professionnels de santĂ© et l’entourage Ă  ces risques liĂ©s Ă  l’exposition Ă  la nicotine

    Ingestion de billes d’eau Analyse des cas enregistrĂ©s par les Centres antipoison du 1er janvier 2010 au 31 dĂ©cembre 2019: Rapport d’étude de toxicovigilance

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    Les billes d’eau ou perles d’eau, formĂ©es de polymĂšres superabsorbants (PSA), sont vendues pour un usage dĂ©coratif, pour l’hydratation des plantes, comme composants de jouets voire en tant que jouets Ă  part entiĂšre. Elles peuvent Ă©galement ĂȘtre employĂ©es pour des utilisations ludiques ou crĂ©atives. Par immersion dans l’eau, ces billes de PSA ont la propriĂ©tĂ© d’augmenter de volume, jusqu'Ă  plusieurs centaines de fois Ă  partir de leur volume dĂ©shydratĂ©. En effet, les PSA sont des hydrogels, c’est-Ă -dire des polymĂšres qui ont la capacitĂ© d’absorber plusieurs centaines de fois leur masse en eau. Ils ont Ă©tĂ© utilisĂ©s dĂšs les annĂ©es 1960 en agriculture pour maintenir l’humiditĂ© des sols. Leurs usages ont ensuite Ă©tĂ© Ă©largis comme agent de rĂ©tention des liquides dans les couches pour bĂ©bĂ©s ou les protections hygiĂ©niques. Souvent multicolores, ces billes de PSA sont attractives pour de jeunes enfants qui peuvent les confondre avec des bonbons et les avaler. Si elles n’ont pas atteint leur taille maximale au moment oĂč l’enfant les avale, elles peuvent continuer Ă  gonfler dans le tube digestif et causer une occlusion intestinale.En 2017, les autoritĂ©s de santĂ© de Guyane avaient alertĂ© le public sur la circulation de sachets de billes colorĂ©es sous l’appellation « Seven Color Crystal Ball » dans une Ă©cole et le risque de confusion avec des bonbons (ARS Guyane, 2017).C’est dans ce contexte qu’un dĂ©cĂšs par occlusion intestinale chez un enfant de deux ans a Ă©tĂ© dĂ©plorĂ© en France en 2019Suite Ă  cela, fin dĂ©cembre 2019, la Direction GĂ©nĂ©rale de la SantĂ© (DGS), la Direction GĂ©nĂ©rale de la Concurrence, de la Consommation et de la RĂ©pression des Fraudes (DGCCRF) et l’Agence nationale de sĂ©curitĂ© sanitaire de l’alimentation, de l’environnement et du travail (Anses) alertaient les consommateurs sur le danger de ces produits. UncommuniquĂ© de presse2 a Ă©tĂ© rĂ©digĂ© Ă  partir des cas enregistrĂ©s par les centres antipoison (CAP) entre le 1er janvier 2010 et le 31 dĂ©cembre 2019 (Anses, 2019). Le prĂ©sent document constitue le rapport descriptif de ces cas. Le communiquĂ© a Ă©tĂ© relayĂ© Ă  l’Union nationale des associations familiales, au rĂ©seau de professionnels de la pĂ©rinatalitĂ©, de la protection materno-infantile et Ă  l’éducation nationale, pour qu’il soit diffusĂ© au personnel enseignant
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