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J R Laporte

Publications and source records attributed to J R Laporte.

At least 73 records · Page 4Linked to original sources
PubMed1990

End-stage renal disease and non-narcotic analgesics: a case-control study.

1. To assess the risk of end-stage renal disease (ESRD) associated with the regular use of three classes of non-narcotic analgesics, we performed a case-control study of 340 patients with ESRD on a haemodialysis maintenance program and 673 hospital controls. 2. The overall odds ratio estimate for non-narcotic analgesics taken at least every other day for 30 days or longer before the first symptom of renal disease was 2.89 (95% CI, 1.78 to 4.68). 3. The risk increased in relation to the use duration. 4. The previous regular consumption of combinations containing phenacetin was strongly associated with ESRD (odds ratio, 19.05; 95% CI, 2.31 to 157.4). The odds ratio for previous regular consumption of salicylates was 2.54 (95% CI, 1.24 to 5.20) and for pyrazolones 2.16 (95% CI, 0.87 to 5.32). 5. An analysis for possible confounding by a history of repeated headaches, arthritis, kidney stones, hypertension, and diabetes did not alter the results. 6. The odds ratio estimates for different pathological subgroups of ESRD patients in relation to previous use of any non-narcotic analgesic were glomerulonephritis. 10.57 (95% CI, 1.25 to 89.0), interstitial nephritis, 3.33 (95% CI, 1.21 to 9.17), cystic kidney disease, 0.71 (95% CI, 0.25 to 1.97), and unknown, 5.15 (95% CI, 2.29-11.57). 7. The results of this study suggest that the regular consumption of analgesics should be routinely considered as a risk factor for any non-congenital cause of chronic renal failure. They also suggest that the risk of ESRD associated with the regular consumption of phenacetin is much higher than the risk associated with other non-narcotic analgesics.

Adolescent↗
PubMed1989

[Use of benzodiazepines at a general hospital].

Anxiety and insomnia are frequent troubles among hospitalized patients and are often related to the underlying diseases, their diagnosis and treatment or to other conditions of the hospital environment. The primary therapeutic strategy consists of modifying such circumstances. Benzodiazepines may be useful in some patients but patterns of hospital use have been scarcely evaluated. We have studied the use of benzodiazepines in medical and surgical departments of our hospital for a 2-month period. From a total of 754 admitted patients, 116 (15.4%) received benzodiazepines orally, presumably for anxiety and insomnia. The proportion of treated patients differed remarkably oscillating between 4% and 58%. Mean daily doses of benzodiazepines were lower than defined daily doses. The schedules were remarkably rigid: 1) in none of the cases the initial dose nor therapeutic schedule were changed, 2) in most cases, schedules in the elderly were the same as in younger patients, and 3) in 80% of cases, the treatment was maintained till the patient was discharged. The present study emphasizes the necessity to modify overall strategy of the use of benzodiazepines.

Adolescent↗
PubMed1989

Evaluation of cefonicid use in a general hospital.

Recently marketed drugs have limited experience in clinical use. Follow-up evaluation is therefore needed, particularly when these drugs are "restricted use" medicines, such as the second-generation cephalosporins. We present a follow-up of the first use of cefonicid, which was carried out after its substitution for cefuroxime in our hospital. The indication for use, dosing, therapeutic effects, and possible adverse reactions were recorded in 210 of the first 319 medical-surgical inpatients who received cefonicid. Cefonicid was administered to patients who could have been treated with free-use antibiotics on at least 128 occasions; these were cases of community-acquired pneumonia without any risk factor, urinary tract infections, acute exacerbations in patients with chronic lung disease, surgical prophylaxis, and intraabdominal infections. One fatal case of Stevens-Johnson syndrome was seen. Other recorded adverse events were two skin reactions, one tachyarrhythmia with evidence of low cardiac output, six episodes of phlebitis, and nine superinfections during treatment with cefonicid. The use of cefonicid instead of cefuroxime was associated with 20 percent cost savings; however, this study shows that optimal antibiotic prescribing may produce much greater savings.

Adolescent↗
PubMed1989

[Therapeutic consultation: information oriented to clinical problems].

Therapeutical information is progressively becoming more abundant, difficult to cope with and in most cases it consists on the description of drugs rather than focusing on practical problems. In medical practice, however, we are presented with multiple complex therapeutical problems and he should be able to obtain reliable information oriented to the resolution of particular clinical situations. This is practically impossible to achieve with the currently available sources. In this paper we describe a service of therapeutic consultations created with the aim of covering this need of the health care system and as a complement of other therapeutical information. This service receives consultations from different hospitals and elaborates individualized solutions. The system is computerized so that the various solutions are kept in a data base from which the information can be easily retrieved using key words. During its first four years, 525 consults regarding the following matters have been answered: selection of therapeutic strategies (29.7%), diagnosis, attitude and prognosis of adverse reactions (28.4%), documentation (11.4%), use of drugs during pregnancy (11.2%), available preparations, bibliography, interactions, pharmacokinetic, breast feeding and others. The number of consultations has increased up to date. This new service, which can be coordinated by means of a computerized data base network, participating several centers, offers a quick, reliable, direct, and individualized information oriented to particular therapeutical problems at a relatively low cost.

Drug Information Services↗
PubMed1988

[Drugs in the mass media].

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Drug-Related Side Effects and Adverse Reactions↗
PubMed1987

[Drug consumption].

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Drug Utilization↗