How to Manage Self-Poisoning With Baclofen in Alcohol Use Disorder? Current Updates

Specialists in addiction medicine continue to debate whether baclofen is still indicated to treat alcohol use disorders in view of conflicting results as to its efficacy. This review summarizes current knowledge on self-poisoning with baclofen focusing of alcohol-use disorder in order to provide an overview of the reliable scientific knowledge on management of such an intoxication. Moreover, as alcohol-dependent patients experience many psychiatric co-morbidities, the risk in suicide attempt using baclofen seems real. Numerous studies have suggested that patients given daily-doses of baclofen higher than 80 mg/day are more likely to attempt suicides than others. Following an ingestion of a large amount of baclofen, central nervous system depression is usually observed. Seizures require the patient to be admitted in intensive care unit and should be treated like other toxicological seizures. Cardiac complications include prolonged QTc interval, degree heart block, premature atrial contractions, and supraventricular tachycardia, hypotension and bradycardia. In cases of intoxication, the elimination half-life of baclofen may last between 12 and 36 h post-overdose and renal failure is known to delay its clearance. Rarely measured in clinical practice, the toxic level of baclofen blood level ranges from 1.1 to 3.5 mg/l, and coma or fatal intoxication are observed from 6 to 9.6 mg/l. Baclofen withdrawal has been observed but making the diagnosis of withdrawal in case of suspected self-poisoning is difficult as baclofen intoxication and baclofen withdrawal share many clinical signs. Admission to hospital to manage of suicide attempt with baclofen is mandatory and should not be limited to baclofen alone. It needs to include other aspects of the overall care of patients with alcohol disorders (psychological and psychosocial interventions, management of comorbid mental conditions and physical complications)

The Role of Age in Cellular Responses to Microenvironmental Cues as a Breast Cancer Susceptibility Factor

Aging is the critical risk factor for many forms of cancer. We used the mammary gland as a model system to study the impact of age on human epithelia in which age is the greatest risk factor for cancer. Dysfunctional progenitor and luminal cells with acquired basal cell properties accumulate during aging for reasons that are not understood. We evaluated the hypothesis that a novel effect of aging is a defective stem cell regulation by the microenvironment. We identified Axl as a previously unappreciated mammary stem cell marker involved in breast epithelial homeostasis and breast cancer progression. We showed that Axl is a marker of a subpopulation of cKit epithelial progenitors. These progenitors are tightly regulated by the microenvironment, specifically the mechanical properties of the niche. We observed that mechano-response mechanisms in cKit progenitors are altered with age. Thus, tissue-level phenotypes of aging in breast may arise in part due to alterations in the Hippo mechano-signal transduction pathway that lead to reduced efficiency of YAP/TAZ activation. Finally, using mass cytometry, we described the first high-dimensional phenotypic heterogeneity in normal human mammary epithelial cells. Computational analysis using unsupervised population partitioning identified clusters of a specific subset of luminal cells that acquired a more basal phenotype and accumulate with age. Moreover, distinct age-related phenotypic signatures were detectable in cKit-progenitor cells, considered the cell-of-origin for breast cancers. Here, we propose a model where reciprocal interactions between the microenvironment and breast epithelial progenitors are skewed during the aging process, leading to a decrease in breast tissue integrity, and increase in phenotypic divergence and susceptibility to tumorigenesis

L' antibiotique à l'officine (conseils et alternatives naturelles)

MONTPELLIER-BU Pharmacie (341722105) / SudocSudocFranceF

La réglisse, un goût venu de l'enfance

MONTPELLIER-BU Pharmacie (341722105) / SudocSudocFranceF

Ronflement (Rire ou chatiment ?)

MONTPELLIER-BU Pharmacie (341722105) / SudocSudocFranceF

How to Manage Self-Poisoning With Baclofen in Alcohol Use Disorder? Current Updates

International audienceSpecialists in addiction medicine continue to debate whether baclofen is still indicated to treat alcohol use disorders in view of conflicting results as to its efficacy. This review summarizes current knowledge on self-poisoning with baclofen focusing of alcohol-use disorder in order to provide an overview of the reliable scientific knowledge on management of such an intoxication. Moreover, as alcohol-dependent patients experience many psychiatric co-morbidities, the risk in suicide attempt using baclofen seems real. Numerous studies have suggested that patients given daily-doses of baclofen higher than 80 mg/day are more likely to attempt suicides than others. Following an ingestion of a large amount of baclofen, central nervous system depression is usually observed. Seizures require the patient to be admitted in intensive care unit and should be treated like other toxicological seizures. Cardiac complications include prolonged QTc interval, degree heart block, premature atrial contractions, and supraventricular tachycardia, hypotension and bradycardia. In cases of intoxication, the elimination half-life of baclofen may last between 12 and 36 h post-overdose and renal failure is known to delay its clearance. Rarely measured in clinical practice, the toxic level of baclofen blood level ranges from 1.1 to 3.5 mg/l, and coma or fatal intoxication are observed from 6 to 9.6 mg/l. Baclofen withdrawal has been observed but making the diagnosis of withdrawal in case of suspected self-poisoning is difficult as baclofen intoxication and baclofen withdrawal share many clinical signs. Admission to hospital to manage of suicide attempt with baclofen is mandatory and should not be limited to baclofen alone. It needs to include other aspects of the overall care of patients with alcohol disorders (psychological and psychosocial interventions, management of comorbid mental conditions and physical complications)

Cannabis Hyperemesis Syndrome in the Emergency Department: How Can a Specialized Addiction Team Be Useful? A Pilot Study

International audienc

Cannabis Hyperemesis Syndrome in the Emergency Department: How Can a Specialized Addiction Team Be Useful? A Pilot Study

International audienc