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[P04.031] Reversibility of Tardive Syndromes
Deepti Zutshi, Leslie Cloud, Stewart Factor, Atlanta, GA
OBJECTIVE:
To evaluate the frequency and clinical predictors of reversibility of
tardive syndromes (TS) in patients in whom the inciting agent was
stopped. BACKGROUND: Tardive syndromes (TS) are often
debilitating iatrogenic movement disorders caused by dopamine receptor
blocking agents (DRBA). Estimates of reversibility are 30% but this
varies and clinical predictors remain unclear. DESIGN/METHODS: We
completed a retrospective study of 108 TS patients seen between January
2006 and December 2009. TS reversibility was the primary outcome of
interest. Variables recorded included age, sex, ethnicity, primary
diagnosis, presence of diabetes, history of alcohol abuse, offending
agent, duration of exposure, TS type, baseline severity, and treatments
used. The cohort was stratified on the basis of TS reversibility and
student's t-tests and chi-squared tests were used for subgroup
comparisons. Correlations between study variables were evaluated using
Pearson's, Point- and Rank-Biserial correlation coefficients. Logistic
regression was undertaken to identify clinical variables predictive of
TD reversibility. RESULTS: The most common offending agents were
GI DRBA (42%), atypical antipsychotics (36%), and typical antipsychotics
(14%). Seventy-five of the subjects were female, mean age 58.6 years
(SD +/- 17.7). The most common underlying diagnoses leading to DRBA use
were mood disorder and GI illness (38% each) and 26% had classical
dyskinesia, 23% dystonia. Fourteen subjects (13%) had complete
resolution of the TS upon last follow-up. Subgroup analysis comparing
subjects with and without resolution revealed no significant difference
in any study variables. Reversibility was not correlated with any study
variables (highest r<0.2). CONCLUSIONS: This cohort was unique
in that all eliminated the offending agent. The frequency of
reversibility was lower than previously reported. No clinical predictors
of TD reversibility were identified. Inherent weaknesses of
retrospective data collection may explain our results. Prospective
studies are needed to assess predictors of TD reversibility.
Category - Movement Disorders: Tardive Dyskinesia and Paroxysmal Dyskinesia
Wednesday, April 25, 2012 7:30 AM
Session P04: Movement Disorders: Restless Legs Syndrome, and Tardive Dyskinesia (7:30 am-12:00 pm)
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les antibiotiques ont un effet transgénérationnel? Oui. Ce ne serait pas les pesticides combattus par Efa Choly qui seraient en cause? Non et surtout il faut retenir que les faits expérimenatux et cliniques doivent être privilégiés par rapport aux idéologies...
"In this study, tetracycline had no detrimental consequences for
sperm number, female reproduction or body size in either sex. By
contrast, tetracycline-treated males exhibited significantly reduced
sperm viability, and transmitted this toxic effect of tetracycline on
sperm to their untreated sons but not to their F2 grandsons. The
transient nature of this paternally-inherited effect is consistent with
tetracycline-induced epigenetic changes in the male germline.
Exposure to epigenome-modifying agents during critical phases of
development can result in transmission of altered epigenetic states,
involving changes in DNA methylation, histone modifications or
non-coding RNAs, across one to several generations15"
"The increasing evidence for pernicious effects of antibiotics on
spermatogenesis can provide a parsimonious explanation for the
marked decline in human ejaculate quality over the last 60 years27.
Although declining sperm density has generally been attributed to
increased exposure to pesticides and other endocrine disrupting chemicals28,
the onset of this decline29 also coincided with the introduction
and widespread use of antibiotics in the 1950s. In one of the few
studies that have statistically evaluated multiple factors potentially
contributing to male subfertility30, recent use of antibiotics, primarily
penicillin and doxycycline (a derivative of the tretracycline group),
outranked pesticide exposure, welding and smoking as the single
most significant risk factor for oligospermia (low sperm count).
Taken together, the results of animal and human studies indicate
that antibiotic use should be given serious consideration as a factor
contributing to human male subfertility, and that further investigation
of the direct and transgenerational effects of antibiotics on male
reproductive function in model organisms is clearly warranted."
http://www.nature.com/srep/2012/120426/srep00375/pdf/srep00375.pdf
Le corps humain n'est pas un réservoir qu'il suffirait de vider, filtrer... L'épigénome est influencé par TOUS LES INTRANTS!
samedi 28 avril 2012
vendredi 27 avril 2012
Comparer et agir... Les coûts du travail.
Même avec la récession les couts horaires augmentent comment voulez vous que les entreprises de France et d'autres pays s'en sortent?