Benedikt Fischer, Deanna Cape, Natalie Daniel, Louis Gliksman
{"title":"Methadone treatment in Ontario after the 1996 regulation reforms. Results of a physician survey.","authors":"Benedikt Fischer, Deanna Cape, Natalie Daniel, Louis Gliksman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Over two decades of rather restrictive regulations have kept the availability of methadone treatment (MT) at low levels in the province of Ontario, Canada. Regulatory changes in the Province of Ontario in the mid-1990s relaxed relevant authorization and treatment practice guidelines. Subsequently, the number of physicians authorized for methadone treatment and treatment spots increased substantially. A large number of the newly authorized physicians are general/local medical practitioners. This study reports on the results of a survey conducted with the majority of MT prescribing physicians in Ontario authorized at the time of study. Physicians were surveyed on their attitudes and practices with regards to the MT authorization system, treatment approaches, requirements and workload, patient 'stability', additional opiate substitution treatment needs, and with regards to general issues and concerns about the new MT governance system. The article also discusses patterns and differences that were found between physicians when comparing their geographic location, whether they see themselves practicing under a 'harm reduction' or an 'abstinence' approach, and whether they received MT authorization under the old or the new guidelines. It is concluded that the liberalized regulations and the increased incorporation of local physicians seems to provide for an overall more desirable system of governance of MT. However, some relevant concerns about the current system exist and are discussed.</p>","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"153 7 Suppl","pages":"2S11-21"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22187049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robert Moulias, Agathe Raynaud-Simon, Sophie Moulias, Sylvie Meaume
{"title":"[Immunity, autoimmunity, and the aging process: complex interactions].","authors":"Robert Moulias, Agathe Raynaud-Simon, Sophie Moulias, Sylvie Meaume","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Immune deficiency is not an age-related process, but rather a progressive process where predominantly cellular immune response is gradually, but never totally, replaced by antibody response. Cellular immune response appears to be associated with the intrinsic mechanisms of pathological aging. Cellular immunity resulting from induction of macrophage stimulation and cytokine secretion appears to involved. These immuno-inflammatory changes mimic the effects of pathological aging in the different organs. Are they essential factors or simply accessory phenomena? Switching towards an antibody response appears to be a mechanism of adaptation rather than a mechanism of deterioration. Immune status provides a good means of assessing general status in an elderly subject. An attempt should be made to identify the cause of any immune deficiency since age is not in itself an underlying cause. Etiological treatment is indicated.</p>","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"153 7","pages":"441-5"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22257235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Informing the hepatitis C diagnosis and the liver biopsy decision. A painful case].","authors":"Michel Ruel","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"153 7 Suppl","pages":"2S45-6"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22187607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Nutrition and immunity in the elderly].","authors":"Sophie Moulias","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Global malnutrition (reduced intake or increased requirements for protein and calories) is the most common nutritional deficit in the elderly population. Micronutrients (vitamins and trace minerals) deficiencies are also common in older adults. Malnutrition consequences on immunity are characterized by a decrease in cell mediation immunity with a reduction in naive T cells and in cytokine production. During infection, the treatment must be specific and after infection it has to associate nutritional supplementation and exercise. The lack of clear benefit in the use of specific micronutrient should discourage the use of high-dose supplementation for an immunologic indication.</p>","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"153 7","pages":"446-9"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22257236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Monoclonal gammopathy of undetermined significance].","authors":"P. Chaïbi, L. Merlin, C. Thomas, F. Piette","doi":"10.32388/ir51hb","DOIUrl":"https://doi.org/10.32388/ir51hb","url":null,"abstract":"Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic disorder with serum monoclonal immunoglobulin less than 30 g/l. It preferentially affects elderly patients; MGUS prevalence is about 1% in the general population and about 10% in patients aged over 80 years. MGUS diagnosis is based on elimination of other causes of serum monoclonal immunoglobulin, particularly multiple myeloma. Within the 20 years following diagnosis of MGUS, about 25% of patients will evolve towards myeloma or other malignant lymphoproliferative disorder. No factor has been identified to date which can efficiently predict this evolution. Recent data concerning immunophenotype, cytogenetics and molecular biology of plasma cells demonstrate the link between MGUS and multiple myeloma. MGUS clearly appears now as a plasma cell monoclonal pathology with reduced malignity. Soon, new biological data would help to discriminate patients with MGUS who will remain asymptomatic life-long from those who will evolve towards malignant lymphoproliferative disorder.","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"153 7 1","pages":"459-66"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69632394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Bupropion: risks and advantages of its use. What preclinical research says].","authors":"Florence Noble","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There is evidence that nicotine, the major constituent of cigarette smoking, leads to addiction. Although a high percent of smokers express the desire to quit, only a small percentage of them are successful in achieving sustained abstinence. Until recently, pharmacological options for treatment of tobacco dependence were primarily limited to the various nicotine replacement therapies. Bupropion provides clinicians and patients with a new non-nicotine alternative. The mechanisms by which bupropion acts as an aid in smoking cessation are unknown. This article is a review of the few explanations taken from the literature, to answer questions about the potential risks of the use of this atypical antidepressant.</p>","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"153 7 Suppl","pages":"2S37-41"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22187605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Treatment of hepatitis C. Paris 27-28 February 2002].","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"153 7","pages":"467-77"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22256543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pascal Chaïbi, Laurence Merlin, Caroline Thomas, François Piette
{"title":"[Monoclonal gammopathy of undetermined significance].","authors":"Pascal Chaïbi, Laurence Merlin, Caroline Thomas, François Piette","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic disorder with serum monoclonal immunoglobulin less than 30 g/l. It preferentially affects elderly patients; MGUS prevalence is about 1% in the general population and about 10% in patients aged over 80 years. MGUS diagnosis is based on elimination of other causes of serum monoclonal immunoglobulin, particularly multiple myeloma. Within the 20 years following diagnosis of MGUS, about 25% of patients will evolve towards myeloma or other malignant lymphoproliferative disorder. No factor has been identified to date which can efficiently predict this evolution. Recent data concerning immunophenotype, cytogenetics and molecular biology of plasma cells demonstrate the link between MGUS and multiple myeloma. MGUS clearly appears now as a plasma cell monoclonal pathology with reduced malignity. Soon, new biological data would help to discriminate patients with MGUS who will remain asymptomatic life-long from those who will evolve towards malignant lymphoproliferative disorder.</p>","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"153 7","pages":"459-66"},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22256542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}