Therapie最新文献

Medical devices for professional use professional use medical device (DMUPs) are playing an increasingly important role in healthcare systems, driven by the rise of digital technologies. They encompass a wide range of equipment, from robotic surgery to diagnostic software solutions. There is no specific definition for DMUP, which complicates their integration into financing channels. Since years 2010s, two main dynamics have accelerated their spread: on the one hand, technological innovation (robotics, artificial intelligence, remote monitoring, connected objects) improving precision, efficiency, and quality of care; on the other hand, growing pressure on healthcare systems linked to an aging population and medical demographics. In France and Europe, regulatory authorities recognize their potential, while highlighting the difficulties of integrating them into traditional reimbursement frameworks. The French model, centered on the list of reimbursable products and services (LPPR), is ill-suited to DMUPs, particularly heavy equipment and digital medical devices. These are financed through grants or integrated into hospital rates, without any real systematic evaluation. European Regulation (EU) 2017/745 has strengthened clinical requirements, while experiments such as ETAPES have paved the way for innovative financing. Nevertheless, the evaluation of DMUPs remains hampered by the difficulty of demonstrating their clinical value and the insufficient consideration of their organizational impact. In response to these challenges, new approaches are emerging value-based models, broadening evaluation criteria to include organizational gains, and increased use of real-world data. In this context, the Giens 2025 Workshops devoted a round table to the evaluation and financing of DMUPs, in order to propose recommendations tailored to the needs of healthcare, the health system, and manufacturers.

Chemsex refers to the intentional use of psychoactive substances to enhance sexual expériences. It often involves prolonged sexual sessions, multiple partners, and the use of drugs such as GHB, synthetic cathinones, and erectile dysfunction medications. Prevalence estimates vary widely across studies, ranging from 9 to 21% in Europe, reflecting heterogeneity in definitions and populations studied. This practice can be associated to serious health risks, including substance addiction, psychiatric disorders, and increased rates of sexually transmitted infections (STIs), notably HIV and hepatitis C. Intravenous drug use during sex ("slamming") carries particularly high risks. Despite its initial emergence in men who have sex with men (MSM) communities, chemsex is also reported among heterosexual and transgender populations. Effective responses require non-judgmental, multidisciplinary support, combining harm reduction, mental health care, and STI prevention. Healthcare professionals must be trained to recognize and address chemsex-related issues. Further research is needed to better define the phenomenon and inform public health strategies. This article provides a brief review of the characteristics, epidemiology, and potential addictive, infectious, and psychological consequences of chemsex.

Background: Gender differences were reported in Parkinson's disease as well as in drug effects in general.

Objective: The study was performed to investigate putative gender differences in levodopa-related adverse drug reactions (ADRs).

Methods: Using Vigibase®, the global pharmacovigilance database, all ADRs reports with levodopa between 01/01/2000 and 31/12/2024 in adults were included. The main levodopa (motor and non-motor) ADRs were compared between women and men. Results are presented as reporting odds ratios (ROR) with their 95% confidence interval.

Results: Among 2887 ADRs with levodopa, the reporting risk in women was significantly higher for dyskinesia (ROR=1.31 [1.00-1.71]), dystonia (1.41 [1.03-1.93]), nausea-vomiting (2.08 [1.45-2.99]), and significantly lower for hypersexuality (0.10 [0.02-0.42]), dopamine dysregulation syndrome (0.32 [0.14-0.73]) pathological gambling (0.33 [0.14-0.76]) and all ADRs in general (0.48 [0.45-0.52]), with no difference for other ADRs.

Conclusion: This study shows gender-related differences for not only motor (dyskinesia, dystonia) but also non-motor levodopa ADRs.

Background: Physicochemical incompatibilities of parenteral drugs are frequently studied and reported, but are rarely documented for liquid oral drugs. However, in clinical practices, nurses may perform mixtures of several liquid oral formulations. Although such practices are not recommended, there is a lack of scientific evidence to support this statement.

Objective: We aimed to study potential incompatibilities of the most dispensed commercial liquid oral formulations in a psychiatric ward.

Methods: First, a bibliographic analysis was performed. Then, 1:1 mixtures of one commercial liquid specialty and tap water and 1:1:1 mixtures of two commercial formulations and water were realized and controlled both visually and analytically. When a precipitate was formed, the mixture was considered incompatible.

Results: A table of oral liquid drug incompatibilities was compiled, and the need for pharmaceutical expertise on this subject was discussed.

Conclusion: This work is the first report of oral liquid drugs' physicochemical incompatibilities and can lead to an improvement in clinical practices.