[Symptomatic remission and its relationship to social functioning in Tunisian out-patients with schizophrenia]. / Rémission symptomatique et sa relation avec le fonctionnement social chez des patients tunisiens suivis pour schizophrénie.

INTRODUCTION: The concept of symptomatic and functional remission represents an important challenge in the care of the mentally ill, particularly in patients with schizophrenia. Operational criteria for symptomatic remission in schizophrenia have been proposed by Andreasen et al. (2005). Over the last decade, these criteria have been widely validated; however few studies have been conducted outside developed countries. Moreover, the association of symptomatic remission with functional outcome has not yet been established in developing countries including Tunisia, as there may be variability in the social and familial environment. OBJECTIVES: To determine the frequency and associated factors of symptomatic remission in a sample of Tunisian out-patients with schizophrenia and to explore the relationship between symptomatic remission and some indicators of social functioning. METHODS: A cross-sectional study was carried-out on 115 out-patients with schizophrenia (87 males, 28 females, mean age=37.56±10.2 years) in the psychiatry department of the university hospital in Monastir (Tunisia). Nearly all of the patients (98.26%) had been hospitalized at least once in a psychiatric unit. The last hospitalization dated back to 39 months on average (range=6 months to 16 years). Symptomatic remission was assessed by the eight core items of the positive and negative syndrome scale (PANSS). These are the items P1 "Delusions"; P3 "Hallucinatory behavior" and G9 "Unusual thought content" for the positive dimension, the items P2 "Conceptual disorganization" and G5 "Mannerism and disorders of posture" for the disorganization dimension and the items N1 "Blunted affect", N4 "Social withdrawal" and N6 "Lack of spontaneity and flow of conversation" for the negative dimension. A score of mild or less on all eight-core symptoms constitutes symptomatic remission. This symptom level should have been maintained for six months. The social functioning was assessed by the Social and Occupational Functioning Assessment Scale (SOFAS) and the Social Autonomy Scale (SAS) exploring personal care, management of daily life, resource management, the relationship with the outside and the emotional life and relationships social. A multivariate analysis using a binary logistic regression was conducted with as a dependent variable "symptomatic remission" and as explanatory variables the associated variables with symptomatic remission in bivariate analysis with age and gender. RESULTS: The symptomatic remission was observed in 50.4% of patients. The items corresponding to positive dimension (P1, P3 and G9) and the item P2 "conceptual disorganization" had a better predictive value of symptomatic remission. After multivariate analysis, the associated factors of symptomatic remission were the acute of onset (P=0.026), the low score of negative symptoms during the last hospitalization (P=0.017) and the episodic course (P<0.0001). However, age or gender of the patients, educational or socioeconomic level, psychiatric family history, age of onset, duration of untreated psychosis, number and duration of previous hospitalizations, antipsychotic treatment dosage were not associated with symptomatic remission in our sample. The mean score of the SOFAS was 48.47±14.44, and the mean score of the SAS was 56.6±16.84. A significant association was shown between the SOFAS score and the symptomatic remission (P<0.0001) and between the SAS score and the symptomatic remission (P<0.0001). Moreover, a significant association was found between symptomatic remission and occupational activity (P=0.03). CONCLUSION: The frequency of symptomatic remission according the PANSS criteria in our sample is above the average of the reported rates in literature (30 to 60%). This can be explained by the frequency of symptomatic remission in outpatient versus inpatients, or in relation to the notion of a more favorable course of schizophrenia in developing countries, although this notion is controversial. Remitter patients had significantly an acute onset of disorders, a low score of negative symptoms during the last hospitalization and an episodic course. They also showed a significant trend for better social functioning. In fact, a significant association was shown in our sample between symptomatic remission and social functioning. These results suggest that the concept of remission has important implications for the treatment of patients with schizophrenia.

Screening and quantification of antibiotic residues in broiler chicken meat and milk in the central region of Algeria. / Recherche et quantification des résidus d'antibiotiques dans le muscle du poulet de chair et dans le lait dans la région centre d'Algérie.

Antibiotics used in animals may be found in food of animal origin and pose a risk to human health. The aim of this study was to screen for antibiotic residues in broiler chickens and milk. Two hundred and twenty-one samples were collected (71 samples of chicken breast meat, 117 samples of raw cow's milk and 33 samples of raw goat's milk). The chicken meat samples underwent a microbiological analysis, followed by a physical/chemical analysis using high-performance liquid chromatography (HPLC). The milk samples were screened using a commercial microbiological test, followed by a further test for residues of beta-lactams and tetracyclines. For chicken meat, 32.39% of the samples were positive, with 56.52% of these samples containing aminoglycosides, 52.17% containing sulphonamides, 30.43% containing beta-lactams and/or tetracyclines and 21.73% containing macrolides. The concentrations of amoxicillin, penicillin G, erythromycin and sulfisoxazole exceeded the maximum residue limits laid down in European regulations in 28.57%, 85.71%, 80% and 91.66% of samples, respectively. The results of the test on milk showed that 12.6% of samples were contaminated by inhibiting substances. Betalactams and tetracyclines were present in 26.32% and 15.79% of the samples analysed, respectively. These results indicate that the contamination of chicken meat and milk is due to non-compliance with administration procedures and inappropiate use of antibiotics.

Les antibiotiques utilisés chez les animaux sont susceptibles de se retrouver dans les denrées alimentaires provenant de ces derniers et constituent un risque pour la santé humaine. Cette étude a pour but la recherche des résidus d'antibiotiques dans le muscle du poulet de chair et le lait. Deux cent vingt et un échantillons ont été collectés (71 échantillons de muscle du bréchet, 117 échantillons de lait cru de vache et 33 échantillons de lait cru de chèvre). Les muscles de poulet ont été analysés par la méthode microbiologique suivie d'une quantification par la méthode physico-chimique de chromatographie en phase liquide à haute performance (HPLC). Les échantillons de lait ont subi un criblage au moyen d'un test microbiologique commercial, suivi d'un autre test pour la recherche des résidus de ß-lactamines et de tétracyclines. Pour le poulet de chair, les résultats ont montré que 32,39% des échantillons sont positifs, dont 56,52% contenant des aminosides, 52,17% des sulfamides, 30,43% des ß-lactamines et/ou des tétracyclines et 21,73% des macrolides. Les concentrations en amoxicilline, en pénicilline G, en érythromycine et en sulfisoxazole sont supérieures aux limites maximales de résidus test fixées par la réglementation européenne dans respectivement 28,57%, 85,71%, 80% et 91,66% des échantillons. Pour le lait, les résultats du test ont montré que 12,67% d'échantillons sont contaminés par des substances inhibitrices. Les ß-lactamines et les tétracyclines sont présentes dans respectivement 26,32% et 15,79% des échantillons analysés. Ces résultats montrent que la contamination de la viande de poulet et du lait est une conséquence du non-respect des modalités d'utilisation des antibiotiques et du mauvais usage de ces derniers.

Los antibióticos utilizados en los animales pueden acabar encontrándose en los productos alimentarios obtenidos a partir de ellos, razón por la cual suponen un riesgo para la salud humana. Los autores describen un estudio encaminado a detectar residuos de antibióticos en la carne de pollos asaderos y en la leche. Para empezar se obtuvieron 221 muestras (71 muestras del músculo de la quilla, 117 muestras de leche cruda de vaca y 33 muestras de leche cruda de cabra). Los músculos de pollo fueron analizados primero por métodos microbiológicos, seguidos de una cuantificación por la técnica físico-química de cromatografía líquida de alto rendimiento (HPLC). Las muestras de leche fueron sometidas a cribado por una prueba microbiológica comercial, seguida de otra prueba para la detección de residuos de ß-lactaminas y tetraciclinas. En el caso de los pollos, los resultados arrojaron un 32,39% de muestras positivas, de las que un 56,52% contenía aminósidos, un 52,17% sulfamidas, un 30,43% ß-lactaminas y/o tetraciclinas y un 21,73% macrólidos. Las concentraciones de amoxicilina, penicilina G, eritromicina y sulfisoxazol superaban los límites máximos de residuos (LMR) fijados en la normativa europea en un 28,57%, un 85,71%, un 80% y un 91,66% de las muestras respectivamente. En el caso de la leche, la prueba Delvotest® SP puso de manifiesto que un 12,67% de las muestras presentaba contaminación por sustancias inhibidoras. Las ß-lactaminas y las tetraciclinas estaban presentes, respectivamente, en un 26,32% y un 15,79% de las muestras analizadas. Tales resultados demuestran que la contaminación de la carne de pollo y la leche es consecuencia del incumplimiento de los procedimientos de administración de antibióticos y del uso inadecuado de estos fármacos.