ABSTRACT
INTRODUCTION: microbial keratitis is a significant health concern for the one million wearers of contact lenses and their ophthalmologists, with some potentially modifiable risk factors. The number of risk factors for contact lens-related microbial keratitis has been described, but many of them still remain assumed or unknown. PATIENTS AND METHODS: a multicenter prospective case-control study was conducted in 12 French university hospitals (Besançon, Bordeaux, Dijon, Fort-de-France, Grenoble, Limoges, Lyon, Nancy, Nantes, Paris, Marseille and Strasbourg) beginning in July 2007 on contact lens wearers presenting with microbial keratitis and on healthy contact lens wearers. Patients and healthy wearers were interviewed using a 51-item anonymous standardized questionnaire to determine subject demographics and contact lens wear history. RESULTS: two hundred and fifty-six patients with microbial keratitis were included. One hundred and thirteen healthy contact lenses wearers were surveyed. Cosmetic contact lens wear highly increased the relative risk (RR) of microbial keratitis (RR, 16.5). Time since the last visit to an ophthalmologist longer than 1 year (RR, 3.4) or prescription by someone other than an ophthalmologist (RR, 7.6) also increased the risk of microbial keratitis. Education on lens care and handling was deficient (hand washing: RR, 2.2; rub and rinse: RR, 2.7). DISCUSSION: a standardized questionnaire is a powerful tool to determine risk factors for contact lens-related microbial keratitis, but also to analyze individual mistakes in contact lenses use and care.
Subject(s)
Contact Lenses/adverse effects , Keratitis/microbiology , Keratitis/prevention & control , Surveys and Questionnaires , Adult , Case-Control Studies , Female , Humans , Male , Prospective Studies , Risk Assessment , Surveys and Questionnaires/standardsSubject(s)
Antidepressive Agents/therapeutic use , Clomipramine/therapeutic use , Depressive Disorder/drug therapy , Piperidines/therapeutic use , Serotonin Antagonists/therapeutic use , Aged , Antidepressive Agents/adverse effects , Clomipramine/adverse effects , Depressive Disorder/psychology , Double-Blind Method , Female , Humans , Male , Middle Aged , Paroxetine , Piperidines/adverse effects , Psychiatric Status Rating Scales , Randomized Controlled Trials as Topic , Serotonin Antagonists/adverse effectsABSTRACT
In a double-blind trial, comprising 96 depressed patients, citalopram was compared with maprotiline. The trial period was 6 weeks with ratings (MADRS, CGI) and side effects recordings taking place at Weeks 0, 1, 2, 4, and 6. Both drugs were administered as a single evening dose, 40 or 60 mg for citalopram, and 75 or 150 mg for maprotiline. MADRS total scores and CGI scores showed a highly significant reduction in both groups with no significant difference between them, whether the groups were considered as a whole or whether they were subdivided into endogenously/non-endogenously depressed or melancholic/non-melancholic patients. Side effects were not significantly different, but the maprotiline group showed more anticholinergic side effects, whereas the citalopram group showed more nausea, increased sweating and headache. Two patients on maprotiline were withdrawn because of side effects (hypotension and somnolence in the one case; tremor and insomnia in the other). One patient in each group was withdrawn because of increased transaminases, the citalopram-treated patient having increased values, however, already at baseline. Apart from this, no cardiovascular side effects and no pathological laboratory values related to treatment were observed. The authors conclude that citalopram is a safe antidepressant drug and as effective as maprotiline.
Subject(s)
Anthracenes/therapeutic use , Depressive Disorder/drug therapy , Maprotiline/therapeutic use , Propylamines/therapeutic use , Adult , Aged , Citalopram , Clinical Trials as Topic , Double-Blind Method , Female , Humans , Male , Maprotiline/adverse effects , Middle Aged , Propylamines/adverse effects , Time FactorsSubject(s)
Chlorhexidine/toxicity , Cornea/drug effects , Animals , Dose-Response Relationship, Drug , Guinea Pigs , SolutionsABSTRACT
Tropatepine hydrochloride was given per oral route to 184 patients and per injections to 34 patients. Average prescribed doses were about 20 mg (2 tablets). This clinical study has shown that tropatepine hydrochloride has an antiparkinson activity against neuroleptic-induced extra-pyramidal syndrome. In comparison to the activity of the other synthetic antiparkinson drugs, the activity of tropatepine hydrochloride is: -- similar on akineto-hypertonia and on tremor; -- better on akathisia and, though less frequently, on anormal dyskinetic movements due to long term neuroleptic treatment. Tolerance is good ; furthermore clinical and biological performed examinations have shown that the drug seems free of toxic effects In more than 200 treated patients no severe mental aberration and no habituation have been reported.
