Journal de la thérapeutique des populations et de la pharamcologie clinique 

About: Journal de la thérapeutique des populations et de la pharamcologie clinique is an academic journal published by Codon Publications. The journal publishes majorly in the area(s): Pregnancy & Population. It has an ISSN identifier of 2561-8741. It is also open access. Over the lifetime, 176 publications have been published receiving 2584 citations. The journal is also known as: Journal de la thérapeutique des populations et de la pharamcologie clinique & JPTCP.

Quantifying the global rates of nausea and vomiting of pregnancy: a meta analysis

Abstract: Background Nausea and vomiting of pregnancy (NVP) is the most common medical condition in pregnancy, affecting women worldwide. It is unclear whether its prevalence and severity NVP are variable across different nations and races. Purpose To summarize global rates of NVP as reported in the literature using meta-analysis. Methods We searched Medline, Embase and Cochrane databases for all peer-reviewed articles reporting rates of NVP and/or hyperemesis gravidarum (HG). No restrictions were imposed on publication year or language. Numbers of women, studies and NVP rates were extracted and aggregated using a random effects model. Outcomes included: overall rates (i.e., women suffering any nausea or vomiting or both) in early and in late pregnancy, rates of nausea only, symptom severity, and HG rates. Results We identified 116 studies, rejecting 37 and accepting 79, of which 59 provided data for NVP (N=93,753 in 13 countries) and 26 for HG (N= 6,155,578). All developed regions of the world were represented (2 studies from Africa, 1 India; none from Latin America). Reported NVP rates varied from 35%-91% (median 69%); the meta-analytic average rate was 69.4% (CI95%:66.5%-72.3%). Among pregnant women, 32.7% had nausea without vomiting and 23.5% overall had NVP continuing into the third trimester. NVP was rated as mild in 40%, moderate in 46% and severe in 14% of cases. The prevalence of HG was 1.1% (CI95%:0.8%-1.3%), with a range of 0.3%-3.6%. Conclusions Almost 70% of women worldwide experience NVP, but reported rates vary widely. HG, the most severe form, affects 1.1%.

A systematic review of treatment of drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in children.

Abstract: Stevens-Johnson (SJS) and Toxic Epidermal Necrolysis (TEN) are two uncommon mucocutaneous diseases usually considered as severe drug reactions and are characterized by different grades of epidermal necrosis. Several treatment modalities have been proposed with variable results but the lack of controlled studies makes difficult to analyze them objectively especially in children. All publications describing management for SJS and TEN in children were searched in MEDLINE, EMBASE, and the Cochrane Library. Reports included were divided in two categories: A, studies with 5 or more patients and observational studies; and B, reports with less than 5 patients. A formal meta-analysis was not feasible. Description was made using central tendency measures. From 1389 references only 31 references with a total of 128 cases were included, 88 category A and 40 category B. The 4 main treatment modalities were: intravenous immunoglobulin (IVIG), steroids (prednisolone, methylprednisolone, dexamethasone), dressings with or without surgical debridement, and support treatment alone. Miscellaneous treatments: Of 12 patients, 3 received ulinastatin, 4 patients plasmapheresis, 2 patients IV pentoxifylline and the last three patients received different treatment each (cyclosporine, methylprednisone/G-CSF and methylprednisolone/IVIG). Patients receiving IVIG and steroids showed similar findings while patients treated with dressing and support treatment alone, reported both longer time to achieve remission and hospitalization stays and appear to be associated with more complications and deaths. There is scant quality literature about management of SJS and TEN in children. Steroids and IVIG seem to improve the outcome of SJS and TEN patients but results from different reports are variable. Patients treated only with care support seem to have higher morbidity and mortality. Further studies are necessary to define optimal management.

Treatment experience, burden, and unmet needs (TRIBUNE) in multiple sclerosis: the costs and utilities of MS patients in Canada.

Abstract: Background Multiple sclerosis (MS) is the most common neurological disease among young adults in Canada, but few studies to date have measured the burden imposed by MS on Canadian society. Objectives To estimate the costs and quality of life of MS patients in Canada, while focusing on the burden of relapses and increasing disease severity. Methods MS patients in Canada (N=241) completed a web-based questionnaire which captured information on demographics, disease characteristics, severity (Expanded Disability Status Scale [EDSS]), comorbidities, relapses, as well as resource consumption and quality of life associated with MS. Results Most patients (74%) reported treatment with disease modifying therapies (DMTs). 54% of patients with the relapsing-remitting form of the disease with an EDSS score ≤ 5 had experienced at least one relapse in the past year. The mean cost per patient per year increased with worsening disability, and was estimated at Can $30,836 for patients with mild disability (EDSS score 0-3), Can $46,622 for patients with moderate disability (EDSS 4-6.5), and Can $77,981 for patients with severe disability due to MS (EDSS score 7-9). The excess costs of relapsing-remitting MS patients with EDSS score ≤ 5 that could be attributable to relapse(s) were estimated at Can $10,512. More severe disease and experiencing a relapse were also associated with poorer quality of life of MS patients. Conclusions Costs of MS patients are higher today than shown in previous studies. Disease progression and relapses are associated with increased economic and quality of life burden. Effective treatment that reduces relapse frequency and prevents progression could impact both costs and quality of life and may help to reduce the societal burden of MS.

Economic burden of nausea and vomiting of pregnancy in the USA.

Abstract: Background Nausea and vomiting of pregnancy (NVP) is the most common medical condition during gestation, affecting 50%-90% of women during their first trimester, and many in the second and third trimester. NVP affects women's quality of life and exerts a large economic impact on patients, caregivers and society. Objectives To estimate the overall economic burden of illness of NVP in the USA. Methods A spreadsheet model was utilized to estimate this burden including direct and indirect costs. Costs are reported in 2012 US dollars and were estimated from the perspective of society. Cost centers included drug treatments for mild to severe NVP and hospitalizations for hyperemesis gravidarum (HG), as well as time lost from work and caregiver time. Clinical, epidemiologic, and economic data were obtained from the literature to populate the model. Rates of drug use were multiplied by unit costs and summed. Results The estimated total economic burden in 2012 in the USA was $1,778,473,782 which included $1,062,847,276 (60%) in direct costs and $715,626,506 (40%) in indirect costs. Overall, the average cost to manage one woman for NVP was $1827. Costs increased with increasing severity of NVP. The estimates were conservative, as not all applicable costs could be included. Conclusions NVP results in a significant economic impact, and hence effective therapy should be sought. Future prospective research should determine in more detail what resources are utilized in the USA to manage women with NVP.

Incidence and prevalence of fetal alcohol spectrum disorder by sex and age group in Alberta, Canada.

Abstract: Objectives To estima te incidence and prevalence of FASD by sex and age in Alberta, Canada. Methods We included all patients recorded in the Alberta provincial health databases of inpatients, outpatients, and practitioner claims from 2003 to 2012. The number of people with F ASD were calculated from available data on FAS (ICD - 9 code 760.71; ICD - 10 codes Q86.0 and P04.3) and estimated prevalence of FASD among individuals diagnosed with 21 FASD - related conditions (identified by a literature review) for which there are ICD codes, such as learning disability, mental retardation, and nervous system defects (Table 1). Fractions of FASD - related diagnoses that can be attributed to alcohol use during pregnancy were estimated by a systematic review. The incidence was measured as the numb er of new cases per 1000 births. The prevalence was measured as the number of cases per 1000 population in 2012. Results Annually, 739 to 1884 people were born with FASD in Alberta establishing an incidence of 14.2 to 43.8 per 1000 births, depending on t he length of follow – up. There were about 46,000 people living with FASD in Alberta 2012, including 6,000 FAS cases and 40,000 FASD - related cases. The prevalence of FASD was 11.7 (range 8.2 to 15.1) per 1000 population. The incidence and prevalence varied g reatly by sex and age group. Generally, male and younger outnumbered female and older. Conclusion This study suggests new incidence and prevalence of FASD, which are higher than what has been commonly used (1%), and its variations among sex and age groups.