ABSTRACT
To evaluate pain management in cancer patients, a study was conducted examining the treatment circumstances and modalities of initial prescription level 3 analgesics used by 122 French cancer specialists. The rationale for moving to level 3, the implementation and the follow-up were evaluated in 1,038 patients. The reasons underlying the initial prescription were in line with recommendations for clinical practice (WHO, SOR) and the professionals generally preferred molecules with which they were already familiar. Though pain intensity was reduced in 67% of patients, treatment follow-up could have been improved in a number of cases. In particular, titration was not systematically performed, and the interruption of the prescribed treatment (owing to inefficacy or negative side-effects) was not sufficiently timely. The awareness-raising campaigns performed over the past few years should be continued, underlining the importance of early follow-up, notably during the titration phase of level 3 analgesic initiation.
Subject(s)
Analgesics, Opioid , Analgesics , Analgesics/therapeutic use , Humans , Neoplasms/drug therapy , Pain/drug therapy , Pain ManagementABSTRACT
OBJECTIVE: To assess the safety, tolerability and efficacy of low-dose ketoprofen (75-150 mg daily for 5 to 15 days) in a general practice setting. DESIGN: Open label, non-controlled study of ketoprofen 25 mg tablets in the treatment of pain in ENT diseases, dysmenorrhoea, and musculoskeletal disorders. SETTING: General practice, 600 investigators SUBJECTS: Four thousand and sixty-eight patients, aged 13-93 years, mean 42.3 years, 1009 with ENT diseases (mean age 38.8 (13-83) years, 53% female), 978 with dysmenorrhoea (mean age 30.3 (13-60) years, 100% female), 2081 with musculoskeletal disorders (mean age 49.6 (16-93) years, 54% female). MAIN OUTCOME MEASURES: Occurrence of adverse events, on patient and physician evaluation; dose and duration of treatment prescribed/taken (diary); global evaluation of efficacy by patient and physician. RESULT: Twenty-two patients were lost to follow-up (<1%); dose effectively taken was lower than prescribed (3.3 versus 3.6 tablets/day); treatment was stopped prematurely in 3.3% of patients because of adverse events, in 17.1% because of early success of therapy. Gastrointestinal adverse events (AE) were the most frequent (76%) of AE), occurring in 10% of patients. They were more frequent in patients with musculoskeletal pain, who were older and had more associated diseases. Five patients were hospitalized, two for preplanned hospitalizations, the others for one asthma attack, one worsening of low back pain, and one angina attack, none attributed to treatment by the GP. None of the AE was life-threatening. Identified risk factors for AE were age and previous medical history, especially of gastrointestinal disorders. CONCLUSIONS: Good quality large scale studies with little or no loss to follow-up can be done in a general practice setting. At the dose used, ketoprofen was generally well tolerated, and used at a lower dose than prescribed, it was not associated with severe or new side-effects. The results of this study could justify its use in self-medication in these indications.
ABSTRACT
Two semi-automatic methods of measuring antibiotic sensitivities were compared to the disk method for everyday use in a bacteriology laboratory. The reproducibility, compared with 3 strains, proved satisfactory, the highest was the API method. There appeared to be few discrepancies between the semi-automatic methods and the disk method. Part of the latter may be explained by the difference of critical concentrations. Others, routine for a few antibiotics, merit more complete study.
Subject(s)
Anti-Bacterial Agents/pharmacology , Microbial Sensitivity Tests/methods , Autoanalysis , Culture Media , Time FactorsABSTRACT
The gram-negative bacteria investigated exert various effects on fatty acids. P. aeruginosa and A. calcoaceticus catabolize any of the fatty acids tested. S. marcescens is effective upon all fatty acids excepting butyric acid. The long chain fatty acids only are degraded by E. coli, meanwhile the other fatty acids present a bacteriostatic or bactericidal activity on it. The authors propose a simple and original method for testing the capability of degradation of fatty acids by some bacterial species.