[Impact of therapeutic advice on prescription of psychotropics for patients with serious mental illness]. / Impact sur la prescription de psychotropes des conseils thérapeutiques formalisés dans un centre référent de réhabilitation psychosociale.

INTRODUCTION: The improvement of prescription constitutes a major challenge for public health. In France, medication is the third cause of serious adverse reaction. The report of the Parliamentary Commission for Evaluation of Health Policy on adequate use of psychotropics mentions their overconsumption. Promoting practices' dissemination and guidelines' respect is one of the missions of the referral psychosocial rehabilitation centers. Therapeutic advice that is offered consists of suggestions for revision in the patient's treatment with the aim of improving the patient's health. To our knowledge, to date no study has focused on the evaluation of therapeutic advice in psychiatry. The present study aimed at analyzing benefits of therapeutic advice for the patients. To this end: (1) a state of things related to actual practices was carried out: psychotropics prescriptions' problems and therapeutic advice proposed by psychiatrists (quantitative and qualitative assessment); (2) the impact of advice on prescription was assessed; (3) patients' benefits were identified. METHOD: This monocentric trial was carried out at the referral psychosocial rehabilitation center of Lyon. This audit was a retrospective observation of electronic medical records (software CortexteNet V2.6). This project was developed by a multidisciplinary staff (pharmacists and psychiatrists) during summer 2015. All patients treated in this center between September 2010 and December 2014 were included. The collection of data was made by two auditors (pharmacist students) thanks to a collection grid with six parts: identification and epidemiology of patients with therapeutic advice, coding tips, benefits, quantitative and qualitative assessment of prescriptions before and after advice. RESULTS: Of the 601 records explored during this study, 66 advices (8.3% of patients) were identified. Patients concerned by therapeutic advice were mainly men with schizophrenia between 35 and 40 years, living in a town and addressed by public psychiatrists. Advice was taken into account in 81.7%, partially in 8.1%, and was beneficial in 97%. The main benefits were clinical improvement (48.5%) and reduction of adverse drug events (36.4%). There were no statistically significant differences between prescriptions (quantitatively and qualitatively) before and after therapeutic advice. CONCLUSION: In most cases, prescriptions of psychotropics were adequate since only 66 advices (8.3% of patients) were given. Psychosocial rehabilitation centers give medication prescribing advice and promote respect of the guidelines. The collaboration between rehabilitation's psychiatrists and other psychiatrists optimizes patient management. It reduces iatrogenic disorders and improves quality and safety of care. Very few studies deal with the prescription of psychotropics in adult psychiatry. This work highlights the positive effect of therapeutic advice for this population. Further controlled studies should clarify the benefits of therapeutic advice.

Retrospective study of 155 cases of prolapse of the nictitating membrane gland in dogs.

A retrospective study of 155 cases (114 dogs). The breed, sex and age at the time of the first and opposite onset of nictitans gland prolapse were recorded. Long-term follow-up with a minimum of one-year duration was performed by telephone conversations. One hundred and fourteen dogs representing 155 nictitans gland prolapses were included. 75.4 per cent of the first prolapse occur before one year of age. Unilateral nictitans gland prolapse was observed in 64 per cent of cases. When the condition was bilateral, it occurred simultaneously in 41.4 per cent. When it was bilateral but not simultaneous (24/41), the opposite gland prolapse occurred within three months in 70.8 per cent of the cases. Five breeds were most commonly affected by the bilateral condition: French bulldog, shar pei, great dane, English bulldog and cane corso.

A case of conjunctival melanoma in a cat.

Since 1985, 5 cases of feline conjunctival melanoma have been reported in the literature. Information on feline conjunctival melanoma epidemiological features, localizations, macroscopic features and histological features is limited. We are describing the clinical, histopathologic features and outcomes in a cat that presented clinically with a slow developing dark brown mass located under the upper eyelid of the left eye. Pertinent literature is reviewed; and the recognizable clinical features and treatment are discussed. The mass was surgically resected. Despite its size, the lesion was easily separated from underlying tissues, making possible a macroscopic complete resection that left intact the adjacent conjunctiva. The tumour histological examination has showed a pigmented melanoma lacking encapsulation, but presenting a clear zone delimiting the lesion. It was exclusively composed of epithelioid cells, and presented mild cellular anaplasia and weak mitotic activity. These features allowed it to be classified as a quite differentiated melanoma with few signs of potential malignancy. In accordance with these histologic features, no recurrence has been registered 34 months after surgery. Thus, a favorable outcome is now reported for two out of six cases of conjunctival melanoma in the cat. This report also confirms the predilection for this neoplasm to arise from the bulbar conjunctiva.

Retrobulbar tumors in dogs and cats: 25 cases.

Twenty-five cases of retrobulbar tumors are presented and discussed. Affected animals were dogs and cats (average 10.7 years). No breed or sex predisposition was noted. The most common clinical signs were exophthalmos (84%), conjunctival hyperemia (40%), protrusion of the nictitating membrane (28%), exposure keratitis (20%) and fundus abnormalities (20%). Diagnostic tools included fine needle aspiration, radiography, ultrasonography, computed tomography and histology. Surgical treatment by orbitotomy or exenteration was combined with chemotherapy and radiotherapy in some cases. The prognosis was poor with low survival times: 1 month in cats, and 10 months in dogs, with a high rate of euthanasia (35%) at the time of diagnosis.

A case of orbital hemangiopericytoma in a dog.

A 7-and-a-half-year-old-dog was presented with progressive unilateral exophthalmos. Computed tomography imaging revealed an orbital mass that was surgically excised by lateral orbitotomy to preserve vision. The tumor was diagnosed histologically as a hemangiopericytoma. Twelve months postoperatively there were no signs of a local recurrence. This is the first case report of a hemangiopericytoma involving the orbit of a dog.

The electroretinographic phenotype of dogs with Golden Retriever muscular dystrophy.

OBJECTIVE: To characterize the flash electroretinogram (ERG) in the Golden Retriever muscular dystrophy (GRMD) dog and to compare the results with those from a control group of Golden Retrievers. To investigate whether similar abnormalities of the ERG as those found in a majority of human patients with Duchenne muscular dystrophy (DMD) are also observed in the GRMD dog, the canine model for DMD. Animals Five GRMD dogs and five age-matched clinically normal Golden Retrievers. PROCEDURE: An ophthalmic examination was carried out prior to performing electroretinography under general anesthesia. Rod, combined rod-cone and oscillatory potentials responses were recorded after dark adaptation. Responses to 30-Hz-flicker were recorded after light adaptation. The ERG responses of the GRMD dogs were compared with those of the control dogs by use of a Wilcoxon signed rank test. RESULTS: GRMD dogs had significantly reduced a and b-wave amplitudes after dim white flash stimuli (rod response) and reduced a-wave amplitude after bright white flash stimuli (rod-cone response). CONCLUSION AND CLINICAL RELEVANCE: The ERG abnormalities observed in the GRMD dog suggest a dysfunction in the rod signaling pathway. These ERG alterations are different from those observed in human patients with DMD.

Long term light-induced retinal degeneration in the miniature pig.

In developing a model of slow light-induced retinal degeneration, ten miniature pigs were submitted to constant lighting for a period ranging from one to three months. Post-lighting survival time ranged from zero to two months. Control and illuminated animals were examined for pupillary reflex, underwent fundus examination and an electroretinogram. After euthanasia, retinas were processed for histology with measure of outer nuclear layer thickness. All animals illuminated one or more months had pupillar reflex alteration. Mean outer nuclear thickness was 24.12 microns in the control and ranged from 18.36 to 21.45 microns in illuminated animals (mean reduction 20%). Despite the pigmentation of miniature pigs, consistent results were obtained in the absence of pharmacologic pupil dilation.

Treatment of keratoconjunctivitis sicca in dogs with cyclosporine ophthalmic ointment: a European clinical field trial.

The results are reported of a six-week clinical trial of the efficacy of 0.2 per cent cyclosporine ophthalmic ointment for the treatment of chronic idiopathic keratoconjunctivitis sicca in dogs in the United Kingdom, Germany and France. The 87 dogs were referral cases with a history of chronic unresponsive keratoconjunctivitis sicca of which the aetiology was unknown, and they had to meet stringent criteria before being included in the trial. The clinical response to the therapy was monitored after seven, 21 and 42 days and the results for the right and left eyes were analysed separately. There was a statistically significant increase in lacrimal secretion throughout the study, with most of the increase occurring during the first week of treatment. The percentage of eyes with improved lacrimal secretion was higher in the dogs with initial Schirmer tear test values > or = 2 mm/min than in those with initial values of 0 or 1 mm/min. The observed steady improvement in conjunctival health was not always correlated with an improvement in lacrimal secretion. The incidence of blepharospasm, other signs of discomfort and corneal oedema decreased significantly during the study. No improvement in corneal vascularisation or pigmentation was observed during the six-week trial. Overall, 76 per cent of the left eyes and 87 per cent of the right eyes were considered to have improved at the end of the treatment period. No serious adverse reactions were observed and only mild irritation was noticed by the owners immediately after the application of the ointment. This irritation resulted in the recording of an adverse reaction at the scheduled observations in only three cases.

[Canine ehrlichiosis in Tunisia. Seroepidemiological survey]. / Ehrlichiose canine en Tunisie. Enquête séroépidémiologique.

The seroprevalence of ehrlichiosis was investigated in 1,216 dogs from eight administrative areas in five regions with different climates. In and around Tunis, where the animals receive satisfactory care, the average prevalence is 49%, but it ranges from 75 to 85% in the other regions of the interior. The authors underline the importance of this disease and describe the conditions which favour its transmission. They also note that the high percentage of asymptomatic carriers provides further proof that Ehrlichia canis is an opportunist pathogen in endemic areas.

Anestesia loco-regional para cirurgia e exames oftalmológicos / Local and regional anesthesia for eye examination an surgery

Em oftalmologia, a anestesia geral näo é suficiente, na maioria dos casos, para a prática da cirurgia, devendo ser completada por uma anestesia loco-regional. No presente artigo, os autores apresentam as técnicas de anestesia loco-regional úteis para a semiologia e a cirurgia oculares, no cäo e no cavalo

[Use of the eye-derived growth factor in the treatment of ulcer of the cornea. A veterinary medicine study in the dog]. / Utilisation du facteur de croissance dérivé de l'oeil dans le traitement des ulcères de cornée. Une étude en médecine vétérinaire chez le chien.

A growth factor purified from adult bovine retina and named Eye Derived Growth Factor (EDGF) has been shown to stimulate proliferation of target cells in vitro and in vivo, and to increase the rate of wound healing of experimentally induced corneal ulcers in rabbits. In the present report, dogs (mainly boxers) with chronic recurrent ulcers resistant to various treatments, including chloramphenicol and reputed wound healing drugs, were treated by morning and evening instillations of drops containing 10 stimulation units of EDGF in phosphate buffer saline. Stable healing of the ulcer was obtained in all cases after 12 days of treatment, and no sign of relapse was detected after three months. During the healing period, as well as during the period of increase in cellular proliferation, transitory inflammation accompanied by neovascularization was observed. EDGF represents a new drug for treatment of ulcer.

[Corneal pathology in the cat and dog]. / La pathologie cornéenne du chat et du chien.

Corneal diseases in the Cat and the Dog are of great variety and present similitudes with human corneal disorders, as demonstrated by the present report which discusses dystrophies, degenerations and inflammations of the cornea successively. Deep endothelial dystrophies are rare, poorly understood, and related to certain breeds; lipid dystrophies are frequent and either primary, occurring in some breeds only, or secondary to hyperlipemia; calcareous dystrophies are breed-related affections. Primary corneal degeneration has been described in the cat only and is a very rare affection. Keratitis is by far the commonest corneal lesion reported, and may be of herpes virus origin in the Cat and due to adenovirus in the Dog. Dry keratitis as in humans has also been observed. Two types of keratitis of allergic origin are described which are closely related to two breeds of dog: Alsatians and the long-haired dachshund. Recurrent corneal erosions, poorly recognized in veterinary medicine, are now described; their etiology and histological appearances are comparable with those reported in humans. These findings emphasize the interest of using animal models for human pathology investigations.