Use of very-high-dose olanzapine in treatment-resistant schizophrenia

International audienc

CFD simulation of premixed flames propagating in an obstacles network

International audienceThe objective of this work is to study the propagation of a premixed flame through numerous obstacles and to observe the flame/obstacle interactions. Several premixed flame models have been evaluated using the OpenFoam software library. They are all based on the evolution of the progress variable and they take into account the increase of the flame speed due to the effects of folding and stretching due to the turbulence. The studied configuration is based on the expansion of a spherical flame within a network of obstacles whose spherical geometry allows fine statistical analyses along the radial direction of the geometry. Various analyses have been carried out based on the temporal evolution of the flame, on the geometric position of its front and finally on the statistical data of its structure. At a given level of turbulence and for an equal volume obstruction rate, whatever the arrangement of the obstacles, it appears that the flame surface developed over time remains substantially identical even if its local topology is very different. On the other hand, if the volume of obstructions varies, the flame surface and therefore its propagation speed is strongly affected. Different correlations for turbulent combustion models have been used: Gulder, FLACS and Zimont. These are the most used in the most common industrial CFD codes. It has been observed that, by properly adjusting the parameters associated with each model, an identical free flame velocity can be found by each model, however, as soon as the flame crosses obstacles, significant variations are observed. This is a logical observation since these models were developed for flame propagation without obstacles. But it seems necessary to consider extensions of these models that would take into account the presence of a given volume obstruction rate

Is the choice between warfarin and fluindion important for patients?

International audienceno abstrac

Clinical Pharmacy in Psychiatry: Towards Promoting Clinical Expertise in Psychopharmacology.

Although clinical pharmacy is a discipline that emerged in the 1960s, the question of precisely how pharmacists can play a role in therapeutic optimization remains unanswered. In the field of mental health, psychiatric pharmacists are increasingly involved in medication reconciliation and therapeutic patient education (or psychoeducation) to improve medication management and enhance medication adherence, respectively. However, psychiatric pharmacists must now assume a growing role in team-based models of care and engage in shared expertise in psychopharmacology in order to truly invest in therapeutic optimization of psychotropics. The increased skills in psychopharmacology and expertise in psychotherapeutic drug monitoring can contribute to future strengthening of the partnership between psychiatrists and psychiatric pharmacists. We propose a narrative review of the literature in order to show the relevance of a clinical pharmacist specializing in psychiatry. With this in mind, herein we will address: (i) briefly, the areas considered the basis of the deployment of clinical pharmacy in mental health, with medication reconciliation, therapeutic education of the patient, as well as the growing involvement of clinical pharmacists in the multidisciplinary reflection on pharmacotherapeutic decisions; (ii) in more depth, we present data concerning the use of therapeutic drug monitoring and shared expertise in psychopharmacology between psychiatric pharmacists and psychiatrists. These last two points are currently in full development in France through the deployment of Resource and Expertise Centers in PsychoPharmacology (CREPP in French)

Psychotropics and COVID-19: An analysis of safety and prophylaxis

International audienceThe use of psychotropics during the COVID-19 pandemic has raised two questions, in order of importance: first, what changes should be made to pharmacological treatments prescribed to mental health patients? Secondly, are there any positive side effects of these substances against SARS-CoV-2? Our aim was to analyze usage safety of psychotropics during COVID-19; therefore, herein, we have studied: (i) the risk of symptomatic complications of COVID-19 associated with the use of these drugs, notably central nervous system activity depression, QTc interval enlargement and infectious and thromboembolic complications; (ii) the risk of mistaking the iatrogenic impact of psychotropics with COVID-19 symptoms, causing diagnostic error. Moreover, we provided a summary of the different information available today for these risks, categorized by mental health disorder, for the following: schizophrenia, bipolar disorder, anxiety disorder, ADHD, sleep disorders and suicidal risk. The matter of psychoactive substance use during the pandemic is also analyzed in this paper, and guideline websites and publications for psychotropic treatments in the context of COVID-19 are referenced during the text, so that changes on those guidelines and eventual interaction between psychotropics and COVID-19 treatment medication can be reported and studied. Finally, we also provide a literature review of the latest known antiviral properties of psychotropics against SARS-CoV-2 as complementary information