Alopécies médicamenteuses non cytotoxiques (revue de la base de données de pharmacovigilance française)

Les alopécies médicamenteuses non chimio-induites sont des effets secondaires rares et peu documentés. Nous avons donc analysé les cas d alopécies enregistrés entre 2006 et 2010 dans la base de pharmacovigilance française dans le but de mieux décrire celles-ci et de faire un point sur les médicaments qui en sont pourvoyeurs. Le diagnostic de perte de cheveux est difficile à établir car il repose essentiellement sur des arguments chronologiques. Même si ce n est pas un problème de santé majeur, l alopécie porte atteinte à l image de soi et doit être prise en considération. Les alopécies que nous exposons affectent davantage les femmes qui y sont de toute évidence plus sensibles. Elles sont généralement de type télogène c est-à-dire d installation progressive et retardée, avec une guérison lente. Même si l origine iatrogène de l alopécie est souvent incertaine, plusieurs cas nous apportent des arguments forts. En s aidant des données des RCP (résumé des caractéristiques du produit) et de données retrouvées dans la littérature, nous avons analysé nos cas et dressé une liste de médicaments pour lesquels l alopécie est un effet indésirable très probable voire certain. Pour quelques-uns, il s agit d un effet encore jamais décrit. En fonction des arguments en notre possession, nous nous sommes parfois positionnés en faveur d une modification du RCP.Non cytotoxic drug-induced alopecia are rare and poorly documented. Therefore we analyzed the cases of alopecia reported between 2006 and 2010 in the French pharmacovigilance database in order to better describe them and show which medicines are providers. Hair loss is difficult to diagnose because it first relies on chronological arguments. Although this is not a major health problem, alopecia affects self-image and must be taken into consideration. It involves more women, probably because they are more sensitive to that kind of changing. Alopecia are generally of telogen type : they appear progressively with delayed recovering. Although the iatrogenic origin of alopecia is often uncertain, we provide several cases with strong arguments. With the help of data from SPC (summary of product characteristics) and literature, we analyzed our cases and built a list of drugs for which alopecia is a very likely or certain side effect. For some of them, this fact has never been disclosed. Sometimes, we came out in favor of an amendment to the SPC.ANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF

Physical Forcing of Phytoplankton Community Structure and Primary Production in Continental Shelf Waters of the Western Antarctic Peninsula

Analyses of a multidisciplinary data set, collected in continental shelf waters of the Western Antarctic Peninsula (WAP) during austral summer of January 1993, identified a previously unrecognized forcing mechanism that sets up a physical and chemical structure that supports and assures site-specific diatom-dominated communities and enhanced biological production (Prézelin et al., 2000). This forcing is active when the southern boundary of the Antarctic Circumpolar Current (ACC) flows along the shelf edge, thereby facilitating onshelf bottom intrusions of nutrient-rich Upper Circumpolar Deep Water (UCDW), which then is upwelled or mixed into the upper water column. At times or locations where UCDW is not introduced to the upper water column, diatoms no longer dominate phytoplankton assemblages over the mid- to outer WAP continental shelf. This analysis extends the area and seasons studied through similar analyses of multidisciplinary data sets collected on four additional cruises to the WAP that cover all seasons. Results show that onshelf intrusions of UCDW: (1) occur in other regions of the WAP continental shelf; (2) are episodic; (3) are forced by nonseasonal physical processes; and (4) produce areas of diatom-dominated phytoplankton assemblages and enhanced primary production. At times, multiple intrusions are observed on the WAP continental shelf, and each event may be in a different stage. Further, the occurrence of an intrusion event in one area does not necessarily imply that similar events are ongoing in other areas along the WAP shelf. The UCDW bottom intrusions originate along the outer shelf but they can extend into the inner shelf region because the deep troughs that transect the WAP shelf provide connections between the inner and outer shelf. The boundary between the intruded water and the shelf water is variable in location because of the episodic nature of the onshelf intrusions, and is moved farther inshore as an event occurs. These observations show clearly that the phytoplankton community structure on the WAP shelf is determined by physical forcing and that primary production is likely to be considerably greater than previously believed. Moreover, variability in this physical forcing, such as may occur via climate change, can potentially affect the overall biological production of the WAP continental shelf system

Shelf circulation and cross-shelf transport out of a bay driven by eddies from an open-ocean current. Part I : interaction between a barotropic vortex and a steplike topography

Author Posting. © American Meteorological Society, 2011. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Physical Oceanography 41 (2011): 889–910, doi:10.1175/2010JPO4496.1.This paper examines interaction between a barotropic point vortex and a steplike topography with a bay-shaped shelf. The interaction is governed by two mechanisms: propagation of topographic Rossby waves and advection by the forcing vortex. Topographic waves are supported by the potential vorticity (PV) jump across the topography and propagate along the step only in one direction, having higher PV on the right. Near one side boundary of the bay, which is in the wave propagation direction and has a narrow shelf, waves are blocked by the boundary, inducing strong out-of-bay transport in the form of detached crests. The wave–boundary interaction as well as out-of-bay transport is strengthened as the minimum shelf width is decreased. The two control mechanisms are related differently in anticyclone- and cyclone-induced interactions. In anticyclone-induced interactions, the PV front deformations are moved in opposite directions by the point vortex and topographic waves; a topographic cyclone forms out of the balance between the two opposing mechanisms and is advected by the forcing vortex into the deep ocean. In cyclone-induced interactions, the PV front deformations are moved in the same direction by the two mechanisms; a topographic cyclone forms out of the wave–boundary interaction but is confined to the coast. Therefore, anticyclonic vortices are more capable of driving water off the topography. The anticyclone-induced transport is enhanced for smaller vortex–step distance or smaller topography when the vortex advection is relatively strong compared to the wave propagation mechanism.Y. Zhang acknowledges the support of theMIT-WHOI Joint Programin Physical Oceanography, NSF OCE-9901654 and OCE-0451086. J. Pedlosky acknowledges the support of NSF OCE- 9901654 and OCE-0451086

The Palmer LTER: A Long-Term Ecological Research Program at Palmer Station, Antarctica

THE ANTARCTIC marine ecosystem-the assemblage of plants, animals, ocean, sea ice, and island components south of the Antarctic Convergence is among the largest readily defined ecosystems on Earth (36 X 106 km2 ) (Hedgpeth, 1977; Petit et al., 1991). This ecosystem is composed of an interconnected system of functionally distinct hydrographic and biogeochemical subdivisions (Treguer and Jacques, 1992) and includes open ocean, frontal regions, shelf-slope waters, sea ice, and marginal ice zones. Oceanic, atmospheric, and biogeochemical processes within this system are thought to be globally significant, have been infrequently studied, and are poorly understood relative to more accessible marine ecosystems (Harris and Stonehouse, 1991; Johannessen et al., 1994). The Palmer Long-Term Ecological Research (Palmer LTER) area west of the Antarctic Peninsula (Fig. la) is a complex combination of a coastal/continental shelf zone and a seasonal sea ice zone, because this area is swept by the yearly advance and retreat of sea ice. The Palmer LTER program is a multidisciplinary program established to study this polar marine ecosystem

BMC Nephrol

Background Early kidney transplantation (KT) is the best option for patients with end-stage kidney disease, but little is known about dialysis access strategy in this context. We studied practice patterns of dialysis access and how they relate with outcomes in adults wait-listed early for KT according to the intended donor source. Methods This study from the REIN registry (2002–2014) included 9331 incident dialysis patients (age 18–69) wait-listed for KT before or by 6 months after starting dialysis: 8342 candidates for deceased-donor KT and 989 for living-donor KT. Subdistribution hazard ratios (SHR) of KT and death associated with hemodialysis by catheter or peritoneal dialysis compared with arteriovenous (AV) access were estimated with Fine and Gray models. Results Living-donor candidates used pretransplant peritoneal dialysis at rates similar to deceased-donor KT candidates, but had significantly more frequent catheter than AV access for hemodialysis (adjusted OR 1.25; 95%CI 1.09–1.43). Over a median follow-up of 43 (IQR: 23–67) months, 6063 patients received transplants and 305 died before KT. Median duration of pretransplant dialysis was 15 (7–27) months for deceased-donor recipients and 9 (5–15) for living-donor recipients. Catheter use in deceased-donor candidates was associated with a lower SHR for KT (0.88, 95%CI 0.82–0.94) and a higher SHR for death (1.53, 95%CI 1.14–2.04). Only five deaths occurred in living-donor candidates, three of them with catheter use. Conclusions Pretransplant dialysis duration may be quite long even when planned with a living donor. Advantages from protecting these patients from AV fistula creation must be carefully evaluated against catheter-related risks

Marine pelagic ecosystems: the West Antarctic Peninsula

The marine ecosystem of the West Antarctic Peninsula (WAP) extends from the Bellingshausen Sea to the northern tip of the peninsula and from the mostly glaciated coast across the continental shelf to the shelf break in the west. The glacially sculpted coastline along the peninsula is highly convoluted and characterized by deep embayments that are often interconnected by channels that facilitate transport of heat and nutrients into the shelf domain. The ecosystem is divided into three subregions, the continental slope, shelf and coastal regions, each with unique ocean dynamics, water mass and biological distributions. The WAP shelf lies within the Antarctic Sea Ice Zone (SIZ) and like other SIZs, the WAP system is very productive, supporting large stocks of marine mammals, birds and the Antarctic krill, Euphausia superba. Ecosystem dynamics is dominated by the seasonal and interannual variation in sea ice extent and retreat. The Antarctic Peninsula is one among the most rapidly warming regions on Earth, having experienced a 28C increase in the annual mean temperature and a 68C rise in the mean winter temperature since 1950. Delivery of heat from the Antarctic Circumpolar Current has increased significantly in the past decade, sufficient to drive to a 0.68C warming of the upper 300 m of shelf water. In the past 50 years and continuing in the twenty-first century, the warm, moist maritime climate of the northern WAP has been migrating south, displacing the once dominant cold, dry continental Antarctic climate and causing multi-level responses in the marine ecosystem. Ecosystem responses to the regional warming include increased heat transport, decreased sea ice extent and duration, local declines in icedependent Ade´lie penguins, increase in ice-tolerant gentoo and chinstrap penguins, alterations in phytoplankton and zooplankton community composition and changes in krill recruitment, abundance and availability to predators. The climate/ecological gradients extending along theWAPand the presence of monitoring systems, field stations and long-term research programmes make the region an invaluable observatory of climate change and marine ecosystem response

Macronutrient supply, uptake and recycling in the coastal ocean of the west Antarctic Peninsula

Nutrient supply, uptake and cycling underpin high primary productivity over the continental shelf of the west Antarctic Peninsula (WAP). Here we use a suite of biogeochemical and isotopic data collected over five years in northern Marguerite Bay to examine these macronutrient dynamics and their controlling biological and physical processes in the WAP coastal ocean. We show pronounced nutrient drawdown over the summer months by primary production which drives a net seasonal nitrate uptake of 1.83 mol N m-2 yr-1, equivalent to net carbon uptake of 146 g C m-2 yr-1. High primary production fuelled primarily by deep-sourced macronutrients is diatom-dominated, but non-siliceous phytoplankton also play a role. Strong nutrient drawdown in the uppermost surface ocean has the potential to cause transient nitrogen limitation before nutrient resupply and/or regeneration. Interannual variability in nutrient utilisation corresponds to winter sea ice duration and the degree of upper ocean mixing, implying susceptibility to physical climate change. The nitrogen isotope composition of nitrate (δ15NNO3) shows a utilisation signal during the growing seasons with a community-level net isotope effect of 4.19 ± 0.29‰. We also observe significant deviation of our data from modelled and observed utilisation trends, and argue that this is driven primarily by water column nitrification and meltwater dilution of surface nitrate. This study is important because it provides a detailed description of the nutrient biogeochemistry underlying high primary productivity at the WAP, and shows that surface ocean nutrient inventories in the Antarctic sea ice zone can be affected by intense recycling in the water column, meltwater dilution and sea ice processes, in addition to utilisation in the upper ocean

High-Resolution Time-Series Data for 1991/1992 Primary Production and Related Parameters at a Palmer LTER Coastal Site: Implications for Modeling Carbon Fixation in the Southern Ocean

Our goal was to provide a high-resolution temporal data base for modeling primary production in shelf waters adjacent to Palmer Station, Antarctica. Here, the resulting 1991/1992 data base is used to: (1) determine in situ productivity over a range of seasonal to subseasonal time scales; (2) identify time scales of significant variability in marine productivity during the peak growing season; (3) identify environmental, experimental and analytical factors that can significantly impact the accuracy of daily, weekly and seasonal productivity estimates; and (4) integrate our findings with previous studies of Antarctic coastal primary pro- duction. Data were gathered every 2–3 days during a 3-month period in the austral spring/summer of 1991/1992. Photosynthesis-irradiance (P-I) relationships were determined throughout the euphotic zone and P-I parameters, combined with knowledge of the in-water light field, were used to derive instantaneous rates of in situ primary production. Additionally, weekly samples were collected from surface and chlorophyll a maxima for characterization of the patterns of diel periodicity in P-I parameters. Seven diel patterns were discerned over the season and used to time-correct instantaneous measurements and derive noontime, daily, monthly and seasonally integrated estimates of production. During the season, a large bloom was responsible for some of the highest daily produc- tivity rates reported for the Southern Ocean (0.8 g C m-3 d-1, 6.3 g C m-2 d-1). Significant variation in daily integrated rates occurred generally on time scales less than a week. Peak timing and magnitude of daytime periodicities in photosynthesis varied widely over the season, closely coupled to changes in phytoplankton community composition. Instantaneous measurements of primary production, if uncorrected or improperly corrected for daytime periodicities in carbon fixation, were unreliable predictors of production on longer time scales even if the water column was sampled every few days. High frequency sampling and consideration of diel periodicity may be requirements when attempting to discern differences between short time-scale variability and long-term trends in Antarctic primary production