Surveillance of gastrointestinal disease in France using drug sales data

AbstractDrug sales data have increasingly been used for disease surveillance during recent years. Our objective was to assess the value of drug sales data as an operational early detection tool for gastroenteritis epidemics at national and regional level in France. For the period 2008–2013, we compared temporal trends of drug sales for the treatment of gastroenteritis with trends of cases reported by a Sentinel Network of general practitioners. We benchmarked detection models to select the one with the best sensitivity, false alert proportion and timeliness, and developed a prospective framework to assess the operational performance of the system. Drug sales data allowed the detection of seasonal gastrointestinal epidemics occurring in winter with a distinction between prescribed and non-prescribed drugs. Sales of non-prescribed drugs allowed epidemic detection on average 2.25 weeks earlier than Sentinel data. These results confirm the value of drug sales data for real-time monitoring of gastroenteritis epidemic activity

Environmental dependency phenomena in schizophrenia: a pilot study

INTRODUCTION: Environmental dependency phenomena refer to the enslavement of patients\u27 performances under the characteristics of the tasks and were first described in case of prefrontal lobe damage. Two forms of environmental dependency, executive and social, may be dissociated, which involve respectively dorsolateral and orbital prefrontal cortex (PFC) dysfunction. Schizophrenia is widely considered to be caused by PFC dysfunction, but no study to date has addressed environmental dependency in this pathology. METHODS: We compared patients (N = 17) and healthy controls (N = 28) on a task dedicated to the study of environmental dependency. RESULTS: Our results demonstrate the presence of environmental dependency in schizophrenia. Each form of environmental dependency can be highlighted independently, as previously demonstrated by studies with prefrontal patients. CONCLUSIONS: These findings suggest specific prefrontal dysfunction for each subgroup of patients and demonstrate a dissociation between socio-cognitive and neurocognitive performance in schizophrenia. Additionally, we found relationships between symptomatology and environmental dependency. This pilot study supports the relevance of studying environmental dependency to highlight specific patterns of prefrontal disorders in schizophrenia, which may contribute to a better understanding of PFC dysfunction in schizophrenia

Lipidic microspheres obtained by a prilling process : from constituents polymorphism to the understanding of the release mechanism of a water soluble drug

Le travail de recherche mené au cours de cette thèse a été effectué dans le cadre d’une collaboration industrielle et a porté sur l’étude des caractéristiques physico-chimiques d’une matrice lipidique à libération prolongée. L’originalité de cette dernière tient à sa forme galénique, des microsphères calibrées d’environ 400 µm de diamètre, fabriquées par procédé de prilling puis conditionnées en sachets.Les caractérisations entreprises au cours de cette thèse ont été menées progressivement en partant de l’étude du comportement thermique individuel des constituants (excipients lipidiques et principe actif), puis de leurs mélanges pour définir les conditions d’existence et les caractéristiques structurales des phases solides qu’ils engendrent, notamment lors du prilling. Plusieurs diagrammes d’état partiels ont été construits pour permettre de cerner l’organisation de la matrice formant le produit fini et disposer de leviers fiables pour corriger d’éventuelles déviations du procédé de fabrication. Cette analyse était également indispensable pour décrire précisément le processus de libération du principe actif et en déterminer les paramètres cinétiques.The research conducted in this thesis, during an industrial collaboration, is focused on the study of physicochemical characteristics of a sustained release lipid matrix. The originality of this matrix is its dosage form, microspheres of 400 microns in diameter, manufactured by a prilling process and packaged in stick-packs.The characterizations conducted during this thesis have been carried out gradually starting from the study of the thermal behavior of individual components (lipidic excipients and drug) and their mixtures to define the phase formation conditions and the structural characteristics of the solid phases generated, especially during the prilling process. Partial phase diagrams were constructed to understand the final product matrix organization and to identify actions to correct any deviations in the process. This analysis was also needed to accurately describe the drug release mechanism and to determine the kinetic parameters