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Biomedical subjects

F Jaquier

Publications and source records attributed to F Jaquier.

3 recordsLinked to original sources

[Hemorrhagic shock due to splenic rupture in non-severe acute pancreatitis].

A 54-year old man was hospitalized for a non severe acute pancreatitis of alcoholic aetiology. Four days after his admission, whilst symptoms and laboratory findings were on the mend, he suddenly presented with acute shock. A CT-scan demonstrated a massive haemoperitoneum due to splenic rupture which necessitated an emergency splenectomy. The causes of shock in acute pancreatitis and the factors that may lead to splenic rupture are discussed. In this patient, a possible role of the non-steroidal anti-inflammatory treatment remains undetermined.

Acute Disease↗

[Torsade de pointes: a severe and unknown adverse effect in a patient taking methadone].

We present here the case of a young drug-addicted patient, who showed a cardio-respiratory arrest attributed to a torsade de pointe-type ventricular arrhythmia. After excluding the usual causes of such arrhythmia, we concluded that it was consecutive to high-dose methadone intake. Methadone can induce torsade de pointe through two mechanisms: a QT interval prolongation secondary to a bradycardia or a prolongation of the myocardial action potential. When prescribing methadone, one should avoid association with other CYP3A4 inhibiting drugs and, if higher doses are necessary, perform regular EKG screening.

Adult↗

[Self medication by the adolescent].

To evaluate the extent and motivations of self-medication, a survey was conducted among 376 adolescents aged 15 to 20 using both written questionnaires and face-to-face interviews. 84% reported having taken some drug during the preceding 15 days, 57% on their own initiative. The most frequently cited drugs were analgesics, vitamins, homeopathy and anti-inflammatory drugs. Psychotropics had been taken by 7% (as self-medication by 3%). Street drugs, mainly cannabis derivatives, had been taken by 18%. The most usual indications for self-medication were headaches (42%), influenza-like syndromes (31%), school-related stress (21%), fatigue (19%) and mood concerns (15%). Most drugs were obtained from family reserves. A multivariate analysis showed self-medication to be associated with complaints regarding headaches, past drug dependency, concerns about illegal drugs or family interactions, recent respiratory illness, and diurnal somnolence. Self-medication increased with age. There was no relationship between self-medication and gender, citizenship, parental education level, or parental drug taking. Nor was self-medication related to knowledge about pharmaceuticals, assessed by specific questions. These results support the interpretation of self-medication mainly as a learned response to psychic/somatic ill-being. An optimal utility/risk ratio for self-prescribed drugs would require public health action and global involvement of practitioners.

Adolescent↗