Publication bias in pharmacogenetics of adverse reaction to antiseizure drugs: An umbrella review and a meta-epidemiological study.

Publication bias may lead to a misestimation in the association between pharmacogenetic biomarkers (PGx) and antiseizure drug's adverse effects (AEs). We aimed to assess its prevalence in this field. We searched for systematic reviews assessing PGx of antiseizure drug's AEs. For each unique association between a PGx, a drug and its AE, we used the available odds ratio (ORs) to generate corresponding funnel plots. We estimated the prevalence of publication bias using visual inspections and asymmetry tests. We explored the impact of publication bias using ORs adjusted for potential publication bias. Twenty-two associations were available. Our visual analysis suggested a publication bias in five out twenty-two funnel plots (23% [95%CI: 8; 45]). The Egger's test showed a significant publication bias in one (HLA-B*15:02 and phenytoin-induced Stevens-Johnson syndrome or toxic epidermal necrolysis, p = 0.03) out of nine (11% [95%CI: 0; 48]) and the Begg's test in one (HLA-B*15:02 and carbamazepine-induced serious cutaneous reactions, p = 0.02) out of ten (10% [95%CI: 0; 45]) assessable funnel plots. Adjusting for publication bias may reduce by half the ORs of the pharmacogenetics associations. Publication bias in the pharmacogenetic of antiseizure drug's AEs is not uncommon and may affect the estimation of the effect of such biomarkers. When conducting pharmacogenetic studies, it is critical to publish also the negative one.

[Chyluria with "nephrotic syndrome-like" presentation: Diagnostic and therapeutic approach]. / Chylurie révélée par un « pseudo-syndrome néphrotique ¼ : démarche diagnostique et thérapeutique.

Chyluria implies an abnormal communication between the lymphatic system and the urinary tract. It is more frequent in endemic areas of lymphatic filariasis, which constitutes the main cause. Chyluria may mimic a nephrotic syndrome. Diagnosis of chyluria is based on urinary cytological and biocheminal analysis. Localization of the fistula needs medical imaging: cystoscopy, retrograde pyelography, lymphoscintigraphy and more recently magnetic resonance lymphography. Due to frequent spontaneous remissions, traitement can require only dietary measures. In case of malnutrition or clinical complications, sclerotherapy should be rapidly undertaken, before considering surgery of renal lymphatic disconnection.

[Physical activity level and home blood pressure measurement: Pilot study "Acti-HTA"]. / Niveau d'activité physique et contrôle ambulatoire de l'hypertension artérielle. Résultats de l'étude pilote « Acti-HTA ¼.

While physical activity (PA) is recommended for high blood pressure management, the level of PA practice of hypertensive patients remains unclear. We aimed to assess the association between the level of both PA and blood pressure of individuals consulting in 9 hypertension specialist centres. Eighty-five hypertensive patients were included (59 ± 14 years, 61% men, 12% smokers, 29% with diabetes). Following their consultation, they performed home blood pressure measurement (HBPM) over 7 days (2 in the morning+2 in the evening), they wrote in a dedicated form their daily activities to estimate the additional caloric expenditure using Acti-MET device (built from International physical Activity Questionnaire [IPAQ]). Thus, patients completed a self-administered questionnaire "score of Dijon" (distinguishing active subjects with a score>20/30, from sedentary<10/30). Subjects with normal HBPM value (<135/85 mm Hg) (55% of them) compared to those with high HBPM were older, had a non-significant trend towards higher weekly caloric expenditure (4959 ± 5045 kcal/week vs. 4048 ± 4199 kcal/week, P=0.3755) and score of Dijon (19.44 ± 5.81 vs. 18.00 ± 4.32, P=0.2094) with a higher proportion of "active" subjects (48.9% vs. 34.2%, P=0.1773). In conclusion, our results demonstrate a "tendency" to a higher level of reported PA for subjects whose hypertension was controlled. This encourages us to continue with a study that would include more subjects, which would assess PA level using an objective method such as wearing an accelerometer sensor.

Diagnosis of malignant hyperthermia susceptibility during CABG surgery.

A 55-year-old man presented for coronary artery bypass graft (CABG) surgery. Malignant hyperthermia (MH) was suspected in his family. This case report describes a diagnostic approach to obtain a definite MH diagnosis by performing an in vitro contracture test at the time of CABG surgery in combination with molecular genetic investigations.

Communication Scale for Older Adults (CSOA).

The communication Self-Assessment Scales for Older Adults (CSOA) are comprised of a 41-item Communication Strategies scale and a 31-item Communication Attitudes scale. Three-point and 5-point response formats are available. The scales were standardized on a population of 135 independent-living adults with hearing loss, ranging in age from 60 to 88 years. Item analysis, internal consistency reliability, test-retest reliability, normative data, and 95 percent confidence intervals are presented. A sample case illustrates how the scales can be used to evaluate the communication strategies and attitudes of an individual client. In addition, data are presented to show changes in the use of communication strategies and attitudes of a group of clients 3 months and 9 months after completion of aural rehabilitation programs.

Revised Communication Self-assessment Scale Inventory for Deaf Adults (CSDA).

The 125-item Communication Self-assessment Scale Inventory for Deaf Adults evaluates difficult communication situations, their importance to the client, communication strategies, and attitudes toward hearing loss. Each scale contains subscales, and the scales may be used independently of each other. The original 115-item scale was revised to improve internal consistency of some of the subscales and modify language in some items. Internal consistency reliability, test-retest reliability, and normative data are presented. The scales were presented to a group of prelingually deaf adults and adolescents who differed in the frequency of hearing aid use, primary mode of communication home, school, and work, and educational background. Subjects responded to some of the scales and subscales in a significantly different manner based on these parameters.

Communication Self-Assessment Scale Inventory for Deaf Adults.

The Communication Self-Assessment Scale for Deaf Adults (CSDA) evaluates difficult communication situations, their importance to the respondent, communication strategies, and communication attitudes. Scale items use simple descriptive language in active declarative form. Each scale is comprised of three or more subscales. The subject responds using a three point semantic differential based on frequency of occurrence or degree of importance. Item analysis, factor analysis, internal consistency reliability studies, and collection of normative data have been performed on a population of 290 deaf adults.