[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 narcotic and buprenorphine poisoning in children notified at the Marseille Poison Center between 1993 and 1999]. / Intoxications accidentelles par stupéfiants et buprénorphine chez les enfants notifiées au Centre Antipoison de Marseille de 1993 à 1999.

To evaluate the frequency and severity of accidental poisoning in children by narcotics or buprenorphine, a retrospective study was carried out: 75 cases were collected by the Marseille Poison Centre between 1993 and 1999. Most of the patients were between 1 and 3 years old and the drugs involved were cannabis and, more recently, Subutex (buprenorphine). These two drugs were responsible for the most severe cases of poisoning, most of which occurred at home.

[Study of narcotics and buprenorphine prescriptions in the Provence-Alps-Côte d'Azur region]. / Etude des prescriptions de stupéfiants et spécialités à base de buprénorphine en région Provence-Alpes-Côte d'Azur.

Following the setting up by the Government of their project for the management of drug addicts, and under the guidance of the CEIP (Centre d'Evaluation et d'Information sur les Pharmacodépendances [Centre for Evaluation and Information on Drug Addiction]) in Marseille, a survey of prescriptions written on controlled-drug prescription pads was performed. The aims were threefold: to study the medicines prescribed, to follow up the legislation and to inform doctors and pharmacists. Copies of the prescriptions, dated between 1 January 1996 and 30 June 1996, which were sent by 81 per cent of the 216 pharmacies contacted in 15 towns in the Provence-Alpes-Côte d'Azur (PACA) region were studied. Various criteria, relating to writing of the prescriptions and distribution of the medicines to the patients, were coded and analysed. This survey showed that of 4 prescriptions, 3 were prescribed for maintenance and one for analgesic therapy. The patients receiving maintenance therapy were male in three-quarters of the cases, and were around 30 years old. Analgesics were prescribed in equal proportions for patients of both sexes, who were around 65 years old. Since it was put on the market, Subutex has been quickly prescribed.

[Mass ciguatera poisoning after eating barracuda in Mexico: prognostic and therapeutic implications]. / Intoxication collective ciguatérique après ingestion d'un barracuda au Mexique: deductions pronostique et thérapeutique.

Thirty patients were admitted to the Anti-Poison Center of Marseille, France, on the fifth day of ciguatera fish poisoning due to ingestion of the same barracuda in Mexico. The purpose of this prospective study conducted during management of this group was to identify prognostic factors and evaluate the efficacy of treatment using mannitol. Upon admission severity was individually scored based on clinical findings. Twenty-two patients exhibiting the highest severity scores were immediately treated by infusion of 250 ml of 20% mannitol within one hour. These patients presented low plasma cholinesterase levels. Treatment led to transient improvement mainly with regard to cramping and digestive manifestations. All patients who presented high severity scores upon admission reported persistent manifestations lasting between 1 and 7 months. In 6 of these patients symptoms recurred after ingestion of seafood and/or alcohol. The fact that the extent of clinical symptoms in terms of severity and duration was correlated with the amount of fish ingested confirms that ciguatera poisoning is dose-dependent in man. However cholinesterase levels were not correlated with the severity of clinical manifestations.