Spurious hyperphosphatemia in a patient with alteplase-locked central venous catheter.

Alteplase has been shown to be effective in preventing central venous access clotting in patients on hemodialysis. Because of a high phosphorus content in its excipient, it can inadvertently contaminate blood samples, leading the physician in care of the patient to erroneously increase dialysis time or change diet in order to control the pseudo-hyperphosphatemia.

A highly sensitive LC-tandem MS assay for the measurement in plasma and in urine of salbutamol administered by nebulization during mechanical ventilation in healthy volunteers.

The new-generation nebulizers are commonly used for the administration of salbutamol in mechanically ventilated patients. The different modes of administration and new devices have not been compared. We developed a liquid chromatography-tandem mass spectrometry method for the determination of concentrations as low as 0.05 ng/mL of salbutamol, corresponding to the desired plasma concentration after inhalation. Salbutamol quantification was performed by reverse-phase HPLC. Analyte quantification was performed by electrospray ionization-triple quadrupole mass spectrometry using selected reaction monitoring detection ESI in the positive mode. The method was validated over concentrations ranging from 0.05 to 100 ng/mL in plasma and from 0.18 to 135 ng/mL in urine. The method is precise, with mean inter-day coefficient of variation (CV%) within 3.1-8.3% in plasma and 1.3-3.9% in urine, as well as accurate. The proposed method was found to reach the required sensitivity for the evaluation of different nebulizers as well as nebulization modes. The present assay was applied to examine whether salbutamol urine levels, normalized with the creatinine levels, correlated with the plasma concentrations. A suitable, convenient and noninvasive method of monitoring patients receiving salbutamol by mechanical ventilation could be implemented. Copyright © 2011 John Wiley & Sons, Ltd.

Unlicensed and off-label drug use in a Swiss paediatric university hospital.

BACKGROUND: Many medicines used in newborns, infants, children and adolescents are not licensed ("unlicensed") or are prescribed outside the terms of the marketing authorization ("off-label"). Several studies have shown that this is a common practice in various healthcare settings in the USA, Europe and Australia, but data are scarce in Switzerland. OBJECTIVES: The aim of our prospective study was to determine the proportion of unlicensed or off-label prescriptions in paediatric patients. METHODS: This pilot study was conducted prospectively over a six month period in the department of paediatrics of a university hospital. RESULTS: Sixty patients aged from three days to 14 years were included in the study. A total of 483 prescriptions were written for the patients. More than half of all prescriptions (247; 51%) followed the terms of the marketing authorization. 114 (24%) were unlicensed and 122 (25%) off-label. All patients received at least one unlicensed or offlabel medicine. CONCLUSION: The use of unlicensed or off-label medicines to treat children was found to be common. Co-operation between the pharmaceutical industry, national regulatory authorities, clinical researchers, healthcare professionals and parents is required in order to ensure that children do not remain "therapeutic orphans".

Pediatric drug-related problems: a multicenter study in four French-speaking countries.

BACKGROUND: Pediatric intensive care patients represent a population at high risk for drug-related problems. There are few studies that compare the activity of clinical pharmacists between countries. OBJECTIVE: To describe the drug-related problems identified and interventions by four pharmacists in a pediatric cardiac and intensive care unit. SETTING: Four pediatric centers in France, Quebec, Switzerland and Belgium. METHOD: This was a six-month multicenter, descriptive and prospective study conducted from August 1, 2009 to January 31, 2010. Drug-related problems and clinical interventions were compiled from four pediatric centers in France, Quebec, Switzerland and Belgium. Data on patients, drugs, intervention, documentation, approval and estimated impact were compiled. MAIN OUTCOME MEASURE: Number and type of drug-related problems encountered in a large pediatric inpatient population. RESULTS: A total of 996 interventions were recorded: 238 (24 %) in France, 278 (28 %) in Quebec, 351 (35 %) in Switzerland and 129 (13 %) in Belgium. These interventions targeted 270 patients (median 21 months old, 53 % male): 88 (33 %) in France, 56 (21 %) in Quebec, 57 (21 %) in Switzerland and 69 (26 %) in Belgium. The main drug-related problems were inappropriate administration technique (29 %), untreated indication (25 %) and supra-therapeutic dose (11 %). The pharmacists' interventions were mostly optimizing the mode of administration (22 %), dose adjustment (20 %) and therapeutic monitoring (16 %). The two major drug classes that led to interventions were anti-infectives for systemic use (23 %) and digestive system and metabolism drugs (22 %). Interventions mainly involved residents and all clinical staff (21 %). Among the 878 (88 %) proposed interventions requiring physician approval, 860 (98 %) were accepted. CONCLUSION: This descriptive study illustrates drug-related problems and the ability of clinical pharmacists to identify and resolve them in pediatric intensive care units in four French-speaking countries.

Demonstration of the effectiveness of zinc in diarrhoea of children living in Switzerland.

We designed a double-blinded randomized clinical trial of zinc (10 or 20 mg of zinc sulphate for 2-5 month-old or 6-59 month-old children, respectively, during 10 days) vs. placebo in otherwise healthy children aged 2 months to 5 years who presented with acute diarrhoea (i.e. ≥3 stools/day for less than 72 h). Eighty-seven patients (median age 14 months; range 3.1-58.3) were analysed in an intention-to-treat approach. Forty-two patients took zinc and 45 placebo. There was no difference in the duration nor in the frequency of diarrhoea, but only 5% of the zinc group still had diarrhoea at 120 h of treatment compared to 20% in the placebo group (P = 0.05). Thirty-one patients (13 zinc and 18 placebo) were available for per-protocol analyses. The median (IQR) duration of diarrhoea in zinc-treated patients was 47.5 h (18.3-72) and differed significantly from the placebo group (median 76.3; IQR 52.8-137) (P = 0.03). The frequency of diarrhoea was also lower in the zinc group (P = 0.02). CONCLUSION: zinc treatment decreases the frequency and severity of diarrhoea in children aged 2 months to 5 years living in Switzerland. However, the intention-to-treat analysis reveals compliance issues that question the proper duration of treatment and the choice of optimal pharmaceutical formulation.

La religieuse de Monza, épisode du XVIIe siècle faisant suite aux "Fiancés" de Manzoni, et traduit de l'italien sur la 8e édition, par Jean Cohen

Titre original : Lamonaca di Monza

L'Artusi overo delle imperfettioni della moderna musica ragionamenti dui. Ne' quali si ragiona di molte cose utili, & necessarie alli moderni compositori. Del R. P. D. Maria Artusi da Bologna,... Novamente stampato

Comprend : Duo [sans texte] ; Vobis datum est noce [sic pour noscere] misterium

Recueil.

1.° Germani Audeberti, Aurelii, ad serenissimam ac christianissimam Reginam Catharinam Medicaeam, Henrici III. Galliae et Poloniae Regis christianissimi matrem, carmen : subjicitur ejusdem interpretatio gallica. — 2.° Lachrymae ad tumulum Christophori Thoï. — 3.° Stanze in lode di Carlo V. Imperatore. — 4.° Carmina ejusdem Audeberti adversùs Poloniam, quùm illic regnaret Henricus. — 5.° Antonii Cerruti carmen ad Joannem Morvillerium, pro Gallorum Regibus apud Senatum Venetum Oratorem. — 6.° Carmen in fugam Caroli V. anno 1552. — 7.° Aliud carmen, quod inscribitur Caesar ; in quo Imperator suis hostibus bellum minatur. — 8.° Les furies de feu Pierre Louis Farnese : poëme francois. — 9.° Satira di Jacobo Sellaro da Cento. — 10.° Sonetti di Francesco Coppetta, Perugino. — 11.° Epitaphe du Duc Philippes de Bourgogne, escript sur sa tombe aux Chartreux de Dijon. — 12.° Epithalamium in nuptias Batorianas. — 13.° Diverses pieces de Remy Belleau. — 14.° Diverses stances sur l'amour. — 15.° Imitation de l'Arioste sur le discours de Roland le furieux, par Philippe Desportes. — 16.° Autres poësies du même. — 17.° Joannis Aurati carmen alternum in nuptias Mariae, Reginae Scotiae, Lotharingia oriundae. — 18.° Michaëlis Hospitalis carmen ad Franciscum Lotharingum, Guisiorum Principem. — 19.° Epistola Francisci Olivarii ad Cardinalem Lotharingum. — 20.° Tetrastichon de Roma. — 21.° Lettre du Prince de Piémont à monsieur l'Evêque d'Orleans, du II. Avril 1559. — 22.° Poëme : le monde passe et sa concupiscence ; par la Rochandieu. — 23.° De la science du salut. — 24.° Epitaphe du nez de maître Pierre Lizet. — 25.° Double du bannissement des Caraffes, affiché aux ruës de Rome après la mort du Pape Paul IV. — 26.° Excerptum è querimonia collegii scortorum Romanensium, de afflicto rerum suarum statu ob exilium Cardinalis Caraffae ; ad Paulum Papam IV. — 27.° Varia epigrammata. — 28.° Canzone di Giovanni Battista Leoni, al serenissimo Henrico, Duca di Angio, eletto Rè di Polonia. — 29.° Joannis Dampetri, Julii Scaligeri, Theodori Bezae, Langaei, Brixii et Olympiae Moratae carmina selecta.

Lois des Lombards.

Acquis le 28 janvier 1843 de Benjamin Duprat, libraire, suite à la vente Saibante pour le prix de 900 francs; cf. B.n.F., département des Manuscrits, registre des acquisitions 1833-1848, n° 3163; — note "Questo codice è assai diffusamente descritto ed illustrato in una epistola di Lucio Doglioni al P. Paolo Canciani, la quale trovasi nel tomo secondo pag. 461 dell' opera: Canciani Barbarorum leges antiquae. Apparteneva al convento di Sa. Eufemia di Verona, indi passo nella Bibltioteca del Mse Gianfilippi" (f. de garde); — Pierre Pithou; cf. B.n.F., département des Manuscrits, nouv. acq. fr. 5527, f. 109

Œuvres de Virgile.

Acquis parmi 44 mss. provenant du cabinet du pape Pie VI 1775-1799 (Giovanni-Angelo Braschi) "peu après l'envoi principal des mss. du Vatican en 1797"; cf. B.n.F., département des Manuscrits, Archives Modernes 492, registre des acquisitions du département des Manuscrits an II-an XIV (1793-1805), f. 49v; Laffitte, Bulletin du Bibliophile, 1989/2, 312

Bible écrite à Florence en 1263.

Acquis parmi 44 mss. provenant du cabinet du pape Pie VI (Giovanni-Angelo Braschi) "peu après l'envoi principal des mss. du Vatican en 1797"; cf. B.n.F., département des Manuscrits, Archives Modernes 492, registre des acquisitions du département des Manuscrits an II-an XIV (1793-1805), f. 48v; Laffitte, Bulletin du Bibliophile, 1989/2, 310