[The community pharmacist and the problem of excessive drinkers]. / Le pharmacien d'officine face au problème des buveurs excessifs.

On a daily basis, the community pharmacist is just as concerned with alcohol (when detecting the interactions between alcohol and medication, or the use of alcohol as an excipient or active ingredient), as with alcoholism (when filling prescriptions, providing advice and guidance to patients, or undertaking other health education actions). In order to define the pharmacist's perception of the problem of alcoholism, an opinion poll was conducted by direct interrogation using a standardised questionnaire. The poll surveyed the owners of 101 randomly selected pharmacies in Puy de Dome. All of the pharmacists questioned are sensitive to and aware of the problem of interactions resulting from mixing alcohol and medication at the time of filling prescriptions. On the other hand, their perception of alcoholism and their behavior towards alcoholic patients vary. They frequently stressed the difficulty of establishing a dialogue. In spite of receiving information and training on alcoholism, perceived as insufficient, pharmacists claim to be really concerned by this problem. As field workers, community pharmacists think that they have a major role to play in carrying out health education campaigns and alcoholism prevention. In fact, the pharmacy is a privileged setting for facilitating encounters and discussions, where alcoholism, like all public health problems, can be addressed.

Usefulness of carbohydrate-deficient transferrin in alcoholic patients with normal gamma-glutamyltranspeptidase.

The biological diagnosis of alcoholism is conducted routinely by assay of gamma-glutamyltranspeptidase (GGT) and mean corpuscular volume (MCV). However, their low specificity and sensitivity have prompted research to find other more reliable parameters. Stibler showed an increase in desialylated transferrin [carbohydrate-deficient transferrin (CDT)] in alcoholic patients. The normal value of the serum CDT concentration is under 60 mg/liter; a value between 60 and 100 mg/liter indicates probable alcoholism, and a value > 100 mg/liter indicates a very high probability of alcoholism (specificity: 99%). Its sensitivity ranges from 60 to 91%, and its specificity ranges from 92 to 100%. Its half-life is 17 +/- 4 days. CDT is thus a useful laboratory marker, but its assay is costlier and more complex than that of GGT. This study concerns 31 alcohol-dependent patients as defined by DSM-IV, with GGT levels in the normal range. It evaluates CDT at day 0 and its time course after 15 days withdrawal. GGT and MCV were assayed concomitantly. Remarkably, the results show a sensitivity of 83.9 (26 positives of 31) in this particular population and a specificity of 92.2. The fall in CDT after 15 days withdrawal was 36%. CDT is thus a particularly useful marker for the diagnosis and follow-up of alcoholics with normal GGT levels.

Changes in oral health conditions among 6- to 15-year-old children in Auvergne (France) 1987-1991.

A representative sample of 1,200 schoolchildren of Auvergne (France) ranging in age from 6 to 15 years was randomly selected. Dental caries experience was determined using the dft, DMFT and DMFS indices. The plaque index and the gingival index were also recorded. Comparison with an identical 1987 study enabled the changes in schoolchildren's dental health to be examined. Significant reductions were observed in all age groups for the DMFT and DMFS indices and in the 6-9-year-old group for the dft index. The mean DMFT score for 12-year-old children was 1.97 in 1991, as compared to the score of 4.62 reported in 1987 (57.3 per cent reduction). While no significant variation was observed in the gingival index, the plaque index decreased significantly for the 7-14-year-old group. The comparison confirmed the trend to a lower caries experience in schoolchildren in Auvergne as in many Western European countries.

[Various mechanic characteristics of bony structures of the temporo-mandibular joint in several classes of mammals studied by measurement of hardness and resistance to penetration]. / Etude de quelques caractéristiques mécaniques des éléments osseux de l'articulation temporo-mandibulaire dans certaines classes de mammifères par duromètrie et pénétrométrie.

Applying the principles of mechanics, the authors have studied and compared the bony structures of the temporo-mandibular joint. Using the means of investigation usually implemented in the metallurgical sector, they have tried to establish a link between the morphology and mechanical strength of the various components of this joint in some subjects belonging to the mammals classification and with various feeding modes. The results obtained by hardness micrometry tend to show that during masticatory movements, the temporo-mandibular joint works in a hanging rather than in a compressed mode.

[Survey of the frequency of dental caries in children 6-15-years of age in the greater central region]. / Enquête sur la fréquence de la carie dentaire chez les enfants âgés de 6 à 15 ans du Massif Central.

A study of the prevalence of dental caries in schoolchildren aged 6 to 15 years living in of the Center of France showed that the disease appeared soon after eruption with a high prevalence in both the deciduous and permanent teeth. The periodontal condition, studied by the plaque, calculus and gingival indices, showed a moderate degree of inflammation.

[Citalopram. An open study of a highly selective serotonin-uptake inhibitor administered by infusion to depressive patients]. / Citalopram. Etude ouverte d'un inhibiteur très sélectif du captage de la sérotonine, administré en perfusion à des patients déprimés.

In an open, clinical trial comprising a total of 49 depressed in-patients, a new selective 5-HT uptake inhibitor citalopram was administered by intravenous infusion in doses of 20-60 mg once daily for per 3 weeks. The therapeutic effect was assessed globally and by means of the CPRS subscale for depression (MADRS). About 40 per cent of the patients showed a complete response whereas about 25 per cent showed a partial response. Side effects which were rated globally and recorded according to a check-list were generally mild and infrequent. The side-effects most frequently observed were tremor, drowsiness, and dizziness which occurred in about 15 per cent of the patients.' Three patients were withdrawn prematurely because of nausea and one because of a skin rash. Cardiovascular recordings were normal except for one patient, who developed a hypertension which may have been related to the test drug. No pathological laboratory values were detected during the trial period. The authors conclude that intravenously administered citalopram is well suited for the treatment of depressed patients.

[Long-term use of 200 mg Dogmatil. Apropos of 13 cases]. / Utilisation au long cours du Dogmatil 200 mg. A propos de treize observations.

A retrospective study of the follow up in 13 patients under maintenance Dogmatil 200 mg treatment (1 to 12 years) establishes the drug's effectiveness and tolerance. The best results were obtained in plain schizophrenia, borderline states and severe neuroses.