STUDY OF DRUG CONSUMPTION IN A WORKING ENVIRONMENT IN FRANCE

1. The present study was conducted to investigate drug consumption in a working environment by means of an anonymous questionnaire given to 2221 subjects and answered in the presence of the work physician. 2. Among the 2221 subjects, 922 had taken at least 1 drug during the week just preceding the medical visit to the company. 3. Women used significantly more hypnotics, sedatives, analgesics, and endocrinologic drugs and homeopathic agents than men, who tended to take more respiratory drugs. 4. Consumption of drugs significantly increased with age. 5. The mean value of estimated difficulty of work was higher in subjects taking drugs in general, as well as hypnotics, sedatives, analgesics, anti-inflammatory agents and gastrointestinal drugs. There was a significant relationship between difficulty of work and total number of medicines taken. 6. Manual workers in general, took no more drugs than nonmanual workers, except for analgesics, anti-inflammatory drugs, and antibiotics. Nonmanual workers used homeopathy more than manual workers. 7. The presence of extraprofessional problems was associated with an increase in drug consumption.     

A Method for Permanent Transvenous Left Ventricular Pacing

LV-based pacing has recently been reported to be of benefit in patients with severe cardiac failure and left bundle branch block. LV permanent pacing has been reported using epicardial leads but the surgical mortality is excessive. A transvenous approach is now favored. In this regard, cannulation of the coronary sinus and of one of its tributaries using only the permanent electrode is feasible but technically challenging. We describe a "long guiding sheath" method using catheterization, and a long radiopaque and peelable sheath. Once the coronaiy sinus is cannulated with the electrophysiological catheter, the long sheath is advanced to the mid-part of the coronary sinus. The permanent pacing electrode is then placed through the sheath and into a tributary of the coronary sinus. This method has been attempted in 10 patients and was successful in 8, with an average lead insertion time of 21 ± 5.5 minutes and an average fluoroscopic time of 11 ± 5.5 minutes. In conclusion, although transvenous left ventricular pacing remains a challenge, the "long guiding sheath" approach appears to facilitate this procedure with both a high success rate and an acceptable procedure time.