Antibiotic safety assessment

Abstract Antibiotics usually have positive risk-benefit ratios, their adverse effects being generally mild and reversible on treatment cessation. However, severe adverse drug reactions (ADR), associated with significant mortality and morbidity have resulted in the withdrawal of several active antibiotics, including new fluoroquinolones. Adverse reactions to antibiotics are often poorly documented. The purpose of this article is to examine current tools for investigating and preventing antibiotic toxicity and to suggest future lines of investigation. Structure/ADR relationships have been investigated with various antibiotics (b-lactams, macrolides, quinolones, etc.) in an attempt to reduce the risk of adverse reactions. Some reactions can be linked to the drug's stereochemical composition. In the case of quinolones for instance, particularly ofloxacin and its derivatives, experimental data show that individual enantiomers have different toxicities. Another major factor that influences the risk of ADRs in a given population is metabolic variability, due to genetic differences in the relevant drug-metabolizing enzymes. Idiosyncratic antibiotic toxicity can be caused by a chemically reactive metabolite. Recent advances in molecular biology, and especially in individual genomic characterization (DNA chip technology, etc.), could in future be useful for identifying patients who are at a special risk of ADR. Finally, certain pharmacokinetic parameters (AUC, Cmax, etc.) can be used to predict adverse effects.

Virological outcomes in ARV-naïve patients switching or not from a first successful boosted PI-regimen to efavirenz, nevirapine or abacavir regimens

International audiencen.

Field-adapted sampling of whole blood to determine the levels of amodiaquine and its metabolite in children with uncomplicated malaria treated with amodiaquine plus artesunate combination

<p>Abstract</p> <p>Background</p> <p>Artemisinin combination therapy (ACT) has been widely adopted as first-line treatment for uncomplicated falciparum malaria. In Uganda, amodiaquine plus artesunate (AQ+AS), is the alternative first-line regimen to Coartem^®(artemether + lumefantrine) for the treatment of uncomplicated falciparum malaria. Currently, there are few field-adapted analytical techniques for monitoring amodiaquine utilization in patients. This study evaluates the field applicability of a new method to determine amodiaquine and its metabolite concentrations in whole blood dried on filter paper.</p> <p>Methods</p> <p>Twelve patients aged between 1.5 to 8 years with uncomplicated malaria received three standard oral doses of AQ+AS. Filter paper blood samples were collected before drug intake and at six different time points over 28 days period. A new field-adapted sampling procedure and liquid chromatographic method was used for quantitative determination of amodiaquine and its metabolite in whole blood.</p> <p>Results</p> <p>The sampling procedure was successively applied in the field. Amodiaquine could be quantified for at least three days and the metabolite up to 28 days. All parasites in all the 12 patients cleared within the first three days of treatment and no adverse drug effects were observed.</p> <p>Conclusion</p> <p>The methodology is suitable for field studies. The possibility to determine the concentration of the active metabolite of amodiaquine up to 28 days suggested that the method is sensitive enough to monitor amodiaquine utilization in patients. Amodiaquine plus artesunate seems effective for treatment of falciparum malaria.</p

Efeitos do estado de humor sobre os comportamentos alimentares inadequados de atletas de atletismo

O objetivo do presente estudo foi analisar os efeitos do estado de humor sobre os comportamentos alimentares inadequados (CAI) em atletas. Participaram 68 atletas de atletismo, do sexo feminino, com idades entre 12 e 17 anos. Utilizaram-se o Eating Attitudes Test (EAT-26) e a Escala de Humor de Brunel (BRUMS) para avaliar os CAI e o distúrbio total do humor (DTH), respectivamente. Dois modelos de regressão linear não indicaram influência estatisticamente significativa da BRUMS nas subescalas Dieta (p=0,42) e Bulimia e Preocupação com Alimentos (p=0,81) do EAT-26. Ao contrário, a BRUMS (p=0,04) demonstrou impacto significante (7%) sobre os escores da subescala Autocontrole Oral. Concluiu-se que as atletas com DTH elevado podem estar mais susceptíveis à influência ambiental para a ingestão alimentar

Paralysie cérébrale et réalité virtuelle, un outil pour l’indépendance ?

Objective: Cerebral palsy includes every brain damages before three years old. It affects more than 17 million people around the world with very different affections of different severity. The occupational therapist follows them during their childhood and after. This research aims to asses the efficiency of virtual reality on the development of independence.Method: Two interviews were conducted with occupational therapists in order to produce a qualitative study. One who works specifically with children with CP and another one who works in rehabilitation with virtual reality tools.Results: The playful component enhanced an important involvement and focus from the child with cerebral palsy. The immersion was essentially used for motor and sensory rehabilitation purposes.Discussion: The use of virtual reality is actually limited to rehabilitation and must be used with caution. According to occupational therapists, this tool must be used as a complement to a conservative rehabilitationObjectif : La paralysie cérébrale regroupe toutes les atteintes du cerveau avant 3 ans. Elle affecte plus de 17 millions de personnes autour du monde avec des atteintes variées et de différents degrés. L’ergothérapeute les suit au long de leur enfance et après. Cette recherche vise à évaluer l’efficacité de la réalité virtuelle sur le développement de l’indépendance.Méthode : Deux entretiens ont été menés auprès d’ergothérapeutes dans le but de produire une étude qualitative. L’un qui travaille spécifiquement avec des enfants paralysés cérébraux et l’autre qui travaille en rééducation avec des outils de réalité virtuelle.Résultats : La composante ludique permet un investissement et une concentration importante de l’enfant avec une paralysie cérébrale. L’immersion est essentiellement utilisée dans un objectif de rééducation motrice et sensorielle.Discussion : L’utilisation de la réalité virtuelle est actuellement limitée à une utilisation rééducative et doit être utilisée avec prudence. Selon les ergothérapeutes, cet outil doit être utilisé seulement en complémentarité d’une rééducation conventionnelle

La myomectomie dans le traitement des fibromes : ses indications, ses possibilités, ses limites, ses résultats /

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