[Doping in sports. Cases reported to the Poison Control Center of Marseille from 1992 to 2000]. / Produits dopants en pratique sportive. Cas notifiés au centre antipoison de Marseille de 1992 à 2000.

OBJECTIVE: To study the doping substances used in sport and their toxicity. METHODS: Retrospective analysis from January 1992 to December 2000 of the cases of use of doping substances in sport reported by telephone to the anti-poison center in Marseilles. RESULTS: Fifty-one cases were reported concerning 48 men and 3 women with a mean age of 30, ranging from 10 to 55 years. Sixty-three percent of cases were reported over the last four years. The sport practiced was bodybuilding, except in 2 cases (cycling in one case and running in the other). The products used were mainly anabolizing hormones (15 times), clenbuterol (14 times) and creatine (7 times). A third of cases concerned associations of substances and 19 cases presented with symptomatology. CONCLUSION: The diversity in nature and status of the substances mentioned and their association requires enhanced vigilance with regard to the use of drugs in sport. The recent measures voted within the framework of the anti-doping law dated 23/3/99 are aimed at increasing surveillance with the development of anti-doping antennae.

[Accidental ingestion of paracetamol in the for of the pediatric syrup EFFERALGAN: case studies during the six months following the institution of the child-proof top]. / Ingestions accidentelles de paracétamol sous la forme de sirop EFFERALGAN pédiatrique: étude des observations au cours des six mois qui ont suivi la mise en place d'un bouchon de sécurité.

During the 6 months following the child-proof top commercialisation for the paediatric syrup EFFERALGAN in France, 51 cases of accidental ingestion were collected by the Marseilles Poison Centre. For 21 pour cent of them, the alleged dose taken was greater than the toxic dose. For 2 cases only, the responsible bottle had a child-proof top and was open on the table. For all other cases, it was simple-opening bottles (old bottles still present in houses, or bottles without a special top but sold in order to get rid of stocks). This study proves that such a preventive measure (modification of the top of the syrup bottles) is only fully effective if additional measures are undertaken such as return of unsold stocks or the provision of information to pharmacists and physicians.

[Accidental ingestions of paracetamol in the form of EFFERALGAN pediatric syrup: experience of the Marseille Anti-poison Center during 1998]. / Ingestions accidentelles de paracétamol sous la forme de sirop EFFERALGAN pédiatrique: expérience du Centre Antipoison de Marseille au cours de l'année 1998.

In 1998, 77 cases of accidental ingestion of paracetamol paediatric syrup (Efferalgan) in children were notified to the Marseille Poison Centre. In a quarter of them, the alleged dose taken was greater than the toxic dose. Ingestion was mainly due to the child opening the bottle. The proximate marketing of a product with a child-proof top, which should allow the number of accidents to be reduced. Doctors and pharmacists should be informed rapidly, so that they can warn the families who still have the old type of bottle.

[Spontaneous rupture of the spleen under ticlopidine. Apropos of two cases]. / Rupture spontanée de la rate sous Ticlopidine. A propos de deux observations.

We observed two cases of spontaneous rupture of an apparently healthy spleen in two patients who were taking ticlopidine as anti-platelet aggregation treatment. The notion that the spleen was apparently healthy was based on well-defined criteria, essential for the imputability of the spontaneous lesions. In general drug-induced spontaneous ruptures of the spleen have been reported for anticoagulants but no case due to antiplatelet aggregation has been reported to our knowledge. The analysis of these two cases and a review of the recent literature suggests that ticlopidine was the causal agent in these two cases of splenic rupture.

[A surveillance method for products used by drug addicts examined in emergency units]. / Essai de mise au point d'une méthode de surveillance des produits utilisés par les toxicomanes consultant dans les services d'accueil.

Products used in a toxicomaniac way are in rapid change, and different from different area. Users too have to be better known. Authors present a simple survey method of these products, based on sample use. First results seem to be correct. These method may be used, associated with others, in a network as those existent for many years in the United States.

[Role of pharmacovigilance center in information for the public on drugs. Experience in Marseille on 9 month]. / Rôle d'un centre de pharmacovigilance dans l'information du public sur le médicament. Expérience à Marseille sur 9 mois.

We analyzed the role of the Marseille pharmacovigilance center (working in collaboration with the local poison treatment center) in informing the general public on medicinal drugs. Over a 9-month period, the center received 115 requests from members of the public for information. 82.6% of callers were not members of the health professions and wanted information for themselves (61.7%, 67.6% women) or their children (26.08%). The questions mainly involved drug interactions (28.7%), side-effects (26%) and precautions for use in particular circumstances (20%). 178 proprietary drugs (47 of which had been bought over the counter) were mentioned. The main therapeutic classes were neuropsychiatric drugs (n = 41), cardiovascular drugs (n = 17) and analgesics (n = 16). A number of communication difficulties and problems of a deontological nature were encountered. Full information was provided in every case, together with advice on prevention to about half the callers.

[Febrile convulsions: should some drugs be contraindicated?]. / Convulsions fébriles: faut-il contre-indiquer certains médicaments?

Should certain drugs be contraindicated in children who have had febrile seizures or who present a risk of convulsions? There are no publications dealing specifically with this problem. However, many drugs can induce convulsions and may be dangerous if they are associated with another determining factor (e.g. fever). Camphor known to be toxic and its use must be avoided in young children. Other terpenes given to children with colds may be convulsant if they are used for prolonged treatment or associated with other convulsant drugs (sympathomimetics, piperazine derivatives, antihistamines, etc.). On the basis of a retrospective study of 23 cases of febrile convulsion among 343 cases of infantile convulsion reported to the Poison Control Center and the Pharmacovigilance Center of Marseille between 1973 and 1991, we propose that camphor and sympathomimetics be avoided and that potential convulsant drugs and their association be used with caution. A prospective study is underway to determine responsibility of certain drugs in the occurrence of recurrence of febrile convulsions.

[Recurrent psychiatric manifestations during malaria prevention with mefloquine. A case report]. / Manifestations psychiatriques récidivantes lors d'une prophylaxie antipaludique par méfloquine. A propos d'un cas.

The authors report the case of a 22 years old woman without psychiatric antecedent who started a prophylaxis with mefloquine for a journey in a chloroquino resistant area. The first tablet induced an acute psychiatric syndrome which lasted five days; the second tablet induced the recidive of the psychiatric data and a suicide attempt by drowning.

[Psychic effects of drugs prescribed for hypertensive patients. An experiment of the Regional Drug Monitoring Center in Marseilles]. / Effets psychiques des médicaments prescrits chez l'hypertendu. Expérience du Centre Régional de Pharmacovigilance de Marseille.

The authors present typical observations of behavioural adverse effects induced by anti-hypertensive drugs and reported to the Marseilles Regional Center of Pharmacovigilance. These effects include: sleep disorders, confusion, psychotic reactions and depression. Surprisingly, these effects seem to be very rarely reported; this is perhaps due to a tricky assessment of the causal relationship: many factors (hypertension, other diseases, other drugs) can have an influence on these troubles.