[A priori prediction of gentamicin peak concentrations: Use of a simple and practical tool]. / Prédiction a priori des concentrations en gentamicine au pic : utilisation d'un outil simple et pratique.

Aminoglycosides are concentration-dependent killing antibiotics, so that it is necessary to obtain elevated peak levels to reach the pharmacokinetic-pharmacodynamic objectives. Because of their nephrotoxicity, this class of antibiotics are frequently underprescribed and giving at an insufficient dosage when prescribed. That is why therapeutical drug monitoring (TDM) of aminoglycosides is recommanded to assess efficacy. Unfortunately, this TDM allows not a dosage adaptation on the first dose of aminoglycosides. The aim of the work was to elaborate a model using simple pharmacokinetics formulae to estimate gentamicin peak levels and so to propose an optimal a priori dosage on the first dose of gentamicin. The final model was tested out on 24 patients treated by gentamicin. The model was able to predict gentamicin peak levels in 62% of patients with a 10% precision and in 79% of patients with a 15% precision. Using this simple and practical tool might avoid under-dosage of gentamicin and clinical failure due to the selection of resistant bacteriae.

The public's knowledge about psychologists and other mental health professionals.

A random sample of New London County, CT, residents received a questionnaire about nine mental health professions or professionals (MHPs): clergyperson, marriage and family counselor, nonpsychiatric physician, psychiatrist, psychiatric nurse, psychologist, psychotherapist, social worker, and telephone crisis counselor. Respondents defined each MHP and reported their satisfaction with treatment, which MHP they would recommend, their referral source(s), licensure requirements, and fees. A mixed-design analysis of variance was computed, with comfortableness as the dependent variable; age, sex, saw an MHP, and education, the between-subjects variables; and the nine MHPs, the within-subjects variable. A significant MHP effect showed that physicians were perceived as slightly more comfortable than were psychologists (nonsignificant), who, nevertheless, were perceived as exceeding all other trained MHPs in the comfortableness experienced by their clients.