[Psychiatric manifestations of laughing gas]. / Effets psychiatriques du gaz hilarant.

Nitrous oxide, also known as laughing gas, is a compound which has long been used as an anesthetic. Due to its euphoric effect and legal status, its recreational use has become probably more and more common and could be considered a compound that presents a risk of abuse. Abuse of nitrous oxide can lead to well-known neurological manifestations but also to psychiatric symptoms that often remain unrecognized. These symptoms will be described in this article.

Le protoxyde d'azote, aussi connu comme gaz hilarant, est depuis longtemps utilisé en tant qu'anesthésiant. En raison de son effet euphorisant mais aussi de sa vente libre, il est également utilisé, probablement de plus en plus, à but récréatif et associé à un potentiel d'abus. Bien que les possibles atteintes neurologiques en lien avec son abus soient bien documentées, cela n'est pas le cas pour les symptômes psychiatriques qui sont souvent méconnus et que nous souhaitons présenter dans cet article.

[Tobacco cessation treatment for people with schizophrenia]. / Traitement pharmacologique d'aide au sevrage tabagique chez les patients souffrant de schizophrénie.

Among patients suffering from schizophrenia, tobacco smoking prevalence is extremely high and represents a major burden in terms of morbidity and mortality. Tobacco smoking is under-diagnosed and under-treated by mental health professionals, mostly due to an overestimated risk of jeopardizing the patient's mental condition, but also due to a lack of expertise on tobacco cessation treatment. Despite the extent of this problem, pharmacological approaches haven't been studied enough. However, treatments such as varenicline, bupropion and nicotine replacement are effective and well tolerated and their prescription should be recommended for tobacco withdrawal among these patients.

La prévalence du tabagisme chez les patients souffrant de schizophrénie est extrêmement élevée et il constitue une charge majeure de morbidité et mortalité pour ces patients. Cependant, cette problématique reste sous-diagnostiquée et sous-traitée par les professionnels de santé mentale, notamment en raison d'une surestimation du risque de décompensation du trouble psychiatrique et par manque de compétences dans le domaine de la tabacologie. Malgré l'ampleur de la problématique, les approches pharmacologiques ont été peu étudiées pour cette population. Néanmoins, la prescription de traitements comme la varénicline, le bupropion et la substitution en nicotine, qui sont bien tolérés et efficaces, est recommandée pour l'aide au sevrage tabagique chez ces patients.

Eighteen-month results of a randomized prospective study comparing transurethral photoselective vaporization with transvesical open enucleation for prostatic adenomas greater than 80 cc.

CONFLICT OF INTEREST: None Take Home Message: This is a prospective randomized study showing that for large prostatic adenomas, photoselective vaporization of the prostate requires less blood transfusions, shorter catheterization time and shorter hospital stay compared to open prostatectomy, while achieving similar functional results at the same time. AIM: The effectiveness and the safety of photoselective vaporization of the prostate (PVP) was compared to that of open prostatectomy (OP) for the surgical treatment of large prostatic adenomas. METHODS: 125 patients with prostate glands>80 ml, were randomly allocated to PVP (n=65) or OP (n=60) and prospectively evaluated at 1, 3, 6, 12, and 18 months postoperatively. International prostate symptom score (IPSS) and peak urinary flow rate (Qmax) were chosen as primary treatment-related endpoints. RESULTS: Longer length of operation time, shorter length of catheterization and hospital stay were experienced by patients who underwent PVP. Although patients who underwent OP showed a higher transfusion rate, adverse events in general were minor and of similar profile in both groups. All functional parameters improved significantly compared to baseline values in both groups. There was no difference in IPSS between the two groups at 3, 6, 12, and 18 months postoperatively. Patients who underwent OP scored better in the IPSS-Quality of life score at 18 months postoperatively. At 18 months there were no significant differences between the two groups in the Qmax, post void residual urine volume and in the International Index for Erectile function-5 questionnaire. At three months prostate volume was significantly lower in the OP group and remained as such throughout follow-up. CONCLUSIONS: Our results indicate that for an 18 month period photoselective vaporization of the prostate is a highly acceptable treatment alternative to open prostatectomy.

Renal colic due to spontaneous perirenal haematoma secondary to antiplatelet medication: two case reports.

We present two cases of spontaneous unilateral perirenal haematoma, following the administration of antiplatelet medication. Both patients reported no history of trauma. One patient was managed conservatively whereas the second patient needed an urgent nephrectomy. A spontaneous haematoma is a rare diagnosis that is easy to be missed. It is important to have a high index of suspicion as a prompt diagnosis can improve the morbidity and mortality of patients. The causes of spontaneous perirenal haematoma are quite varied and a bleeding diathesis can only be accepted as a cause only when all other causes have been excluded.

Transurethral photoselective vaporization versus transvesical open enucleation for prostatic adenomas >80ml: 12-mo results of a randomized prospective study.

OBJECTIVES: To compare the effectiveness and the safety of photoselective vaporization of the prostate (PVP) to open prostatectomy (OP) for the surgical treatment of large prostatic adenomas. METHODS: A total of 125 patients with prostate glands >80ml were randomly allocated to PVP (n=65) or OP (n=60) and prospectively evaluated at 1, 3, 6, and 12 mo postoperatively. International Prostate Symptom Score (IPSS) and peak urinary flow rate (Q(max)) were chosen as primary treatment-related end points. RESULTS: The patients who underwent PVP experienced a longer length of operation time, shorter time of catheterization, and shorter hospital stay. Adverse events were minor and of similar profiles in both groups, although patients who underwent OP showed a higher transfusion rate. All functional parameters improved significantly compared to baseline values in both groups. The IPSS did not differ between the two groups at 3, 6, and 12 mo postoperatively. Patients who underwent OP scored better in the IPSS quality of life score at 6 and 12 mo postoperatively. No significant differences between the two groups in the Q(max), postvoid residual urine volume, and International Index for Erectile Function-5 questionnaire were detected. At 3 mo prostate volume was significantly lower in the OP group compared to the PVP group (median value 10ml vs. 50ml; p<0.001) and remained as such throughout follow-up, whereas prostate-specific antigen values reached statistical difference at 6 mo (median value 2ng/ml vs. 2.4ng/ml; p=0.028). CONCLUSIONS: Our results indicate that for a 12-mo period PVP is a highly acceptable treatment alternative to OP.