Psychiatric and psychological follow-up of undergraduate and postgraduate medical students: prevalence and associated factors. Results from the national BOURBON study. Running title: mental health and addictive behavior of medical students

International audienceBackground. Physicians are at risk of burnout, anxiety and depression. Prevention i

Exploring venlafaxine pharmacokinetic variability with a phenotyping approach, a multicentric french-swiss study (MARVEL study).

It is well known that the standard doses of a given drug may not have equivalent effects in all patients. To date, the management of depression remains mainly empirical and often poorly evaluated. The development of a personalized medicine in psychiatry may reduce treatment failure, intolerance or resistance, and hence the burden and costs of mood depressive disorders. The Geneva Cocktail Phenotypic approach presents several advantages including the "in vivo" measure of different cytochromes and transporter P-gp activities, their simultaneous determination in a single test, avoiding the influence of variability over time on phenotyping results, the administration of low dose substrates, a limited sampling strategy with an analytical method developed on DBS analysis. The goal of this project is to explore the relationship between the activity of drug-metabolizing enzymes (DME), assessed by a phenotypic approach, and the concentrations of Venlafaxine (VLX) + O-demethyl-venlafaxine (ODV), the efficacy and tolerance of VLX. This study is a multicentre prospective non-randomized open trial. Eligible patients present a major depressive episode, MADRS over or equal to 20, treatment with VLX regardless of the dose during at least 4 weeks. The Phenotype Visit includes VLX and ODV concentration measurement. Following the oral absorption of low doses of omeprazole, midazolam, dextromethorphan, and fexofenadine, drug metabolizing enzymes activity is assessed by specific metabolite/probe concentration ratios from a sample taken 2 h after cocktail administration for CYP2C19, CYP3A4, CYP2D6; and by the determination of the limited area under the curve from the capillary blood samples taken 2-3 and 6 h after cocktail administration for CYP2C19 and P-gp. Two follow-up visits will take place between 25 and 40 days and 50-70 days after inclusion. They include assessment of efficacy, tolerance and observance. Eleven french centres are involved in recruitment, expected to be completed within approximately 2 years with 205 patients. Metabolic ratios are determined in Geneva, Switzerland. By showing an association between drug metabolism and VLX concentrations, efficacy and tolerance, there is a hope that testing drug metabolism pathways with a phenotypical approach would help physicians in selecting and dosing antidepressants. The MARVEL study will provide an important contribution to increasing the knowledge of VLX variability and in optimizing the use of methods of personalized therapy in psychiatric settings. ClinicalTrials.gov NCT02590185 (10/27/2015). This study is currently recruiting participants

In Situ Observations of the Deformation Behavior and Fracture Mechanisms of Ti-45Al-2Nb-2Mn+0.8 vol pct TiB₂

The deformation and fracture mechanisms of a nearly lamellar Ti-45Al-2Nb-2Mn (at. pct) + 0.8 vol pct TiB₂ intermetallic, processed into an actual low-pressure turbine blade, were examined by means of in situ tensile and tensile-creep experiments performed inside a scanning electron microscope (SEM). Low elongation-to-failure and brittle fracture were observed at room temperature, while the larger elongations-to-failure at high temperature facilitated the observation of the onset and propagation of damage. It was found that the dominant damage mechanisms at high temperature depended on the applied stress level. Interlamellar cracking was observed only above 390 MPa, which suggests that there is a threshold below which this mechanism is inhibited. Failure during creep tests at 250 MPa was controlled by intercolony cracking. The in situ observations demonstrated that the colony boundaries are damage nucleation and propagation sites during tensile creep, and they seem to be the weakest link in the microstructure for the tertiary creep stage. Therefore, it is proposed that interlamellar areas are critical zones for fracture at higher stresses, whereas lower stress, high-temperature creep conditions lead to intercolony cracking and fracture.The authors are grateful to Industria de Turbo Propulsores, S.A. for supplying the intermetallic blades. Funding from the Spanish Ministry of Science and Innovation through projects MAT2009-14547-C02-01 and MAT2009-14547-C02-02 is acknowledged. The Madrid Regional Government supported this project partially through the ESTRUMAT grant P2009/MAT-1585. C.J.B. acknowledges the support from Grant SAB2009-0045 from the Spanish Ministry of Education for his sabbatical stage in Madrid.Publicad

Psychose : l’importance du facteur migratoire

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SUICIDE ET EVALUATION. REVUE DES OUTILS DISPONIBLES EN FRANÇAIS : APPROCHE NON DIMENSIONNELLE ET AUTO-QUESTIONNAIRES

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Alcohol Consumption for People Admitted in French Emergency Departments: A Protocol for a Multi-Center Cluster Trial

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Follow-up study of patients treated with olanzapine pamoate in France in real-life treatment situation

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