Nicolas Simon - Academia.edu (original) (raw)

Papers by Nicolas Simon

Critical Care Medicine, 1981

Alcoholism: Clinical and Experimental Research, 2014

Baclofen is a GABA-B receptor agonist used in the treatment of spasticity. Recently, baclofen is ... more Baclofen is a GABA-B receptor agonist used in the treatment of spasticity. Recently, baclofen is used out of its label to decrease craving of alcoholic patients. Its optimal use in these patients requires further pharmacokinetic information. The objective of this study was to characterize the pharmacokinetics of baclofen in alcohol-dependent patients. Randomized clinical trials are ongoing to evaluate the efficacy for this new indication. Thirty-seven outpatients (weight: 74.0 kg [42.0 to 104.0]; age: 49 years [31 to 68]) followed in the addictology unit were studied. Total mean dose of 77.9 mg (30 to 240) per day was administered by oral route. Therapeutic drug monitoring allowed the measurement of 139 plasma concentrations. The following covariates were evaluated: demographic data (age, body weight, height, sex), biological data (creatinine, urea, AST, ALT, albumin, PR, VGM, PAL, CDT, GGT), and tobacco consumption (number of cigarettes and Fagerstrom test). Pharmacokinetic analysis was performed by using a nonlinear mixed-effect population model (NONMEM 7.2 software). Data were modeled with a 1-compartment pharmacokinetic model. The population typical mean (95% confidence interval [95% CI]) values for clearance (CL), apparent volume of distribution (V), and rate constant of absorption (Ka) were 9.9 l/h (9.0 to 11.1), 80.7 l (63.6 to 96.9), and 4.6/h (1.5 to 19.9), respectively. The interindividual variability of CL (95% CI) and V (95% CI), and residual variability (95% CI) were 56.0% (47.9 to 60.7), 68.3% (48.7 to 80.1), and 0.096 mg/l (0.079 to 0.107), respectively. Baclofen exhibited a linear pharmacokinetics with a proportional relationship from 30 to 240 mg per day, the dose range currently used in alcoholic patients. A wide interpatient variability was observed which could not be explained by the covariates. This high variation of baclofen exposure may explain the lack of response observed for some patients.

Journal Europeen Des Urgences, Jun 1, 2005

... Minguet, Geneviève Mocquet, Jean-Marc Philippe, Patrick Plassais, Olivier Roquet, Dominique S... more ... Minguet, Geneviève Mocquet, Jean-Marc Philippe, Patrick Plassais, Olivier Roquet, Dominique Santallier, Nicolas Simon, Frédérik Staikowsky, Bertrand Yersin, Xavier Zarka, Quitterie Trevoux,Sandrine Galiegue. ... Les liaisons fortes du SU sont identifiées avant sa conception. ...

Journal Européen des Urgences, 2005

Emergency Medicine Journal, 2011

To determine which measures, other than a reduction in waiting time, could prevent the departure ... more To determine which measures, other than a reduction in waiting time, could prevent the departure of the left-without-being-seen (LWBS) patients in an emergency department. Secondary objectives were description of the characteristics of LWBS patients, analysis of their reasons for leaving and assessment of their medical outcome. A feasibility study was used to establish a telephone survey form. A prospective study of 421 patients was then carried out between 23 November 2006 and 12 February 2007 in the Poissy emergency department. Every LWBS patient whose telephone number was available in the administrative file was included. Patients who could not be contacted within 7 days after their departure were excluded. Statistical analyses were performed using STATA 8.0 software. 12,702 patients were admitted to the emergency department, of whom 421 (3.3%) (95% CI 0.030 to 0.036) left without being seen by a physician. 229 patients (54%) agreed to respond to the survey. 56% of the LWBS patients informed the medical team that they were leaving the emergency department. 74% of the surveyed participants suggested measures that could have helped them wait longer. These measures can be separated into two main categories: an improvement in communication and an improvement in the comfort of the emergency department waiting room. The 'quality' of the waiting time appears to be important in the decision to leave. If this aspect was taken into account, a reduction in the number of LWBS patients and improved quality of care could be achieved in emergency departments.

Anesthesia & Analgesia, 1996

Critical Care Medicine, 1981

Alcoholism: Clinical and Experimental Research, 2014

Baclofen is a GABA-B receptor agonist used in the treatment of spasticity. Recently, baclofen is ... more Baclofen is a GABA-B receptor agonist used in the treatment of spasticity. Recently, baclofen is used out of its label to decrease craving of alcoholic patients. Its optimal use in these patients requires further pharmacokinetic information. The objective of this study was to characterize the pharmacokinetics of baclofen in alcohol-dependent patients. Randomized clinical trials are ongoing to evaluate the efficacy for this new indication. Thirty-seven outpatients (weight: 74.0 kg [42.0 to 104.0]; age: 49 years [31 to 68]) followed in the addictology unit were studied. Total mean dose of 77.9 mg (30 to 240) per day was administered by oral route. Therapeutic drug monitoring allowed the measurement of 139 plasma concentrations. The following covariates were evaluated: demographic data (age, body weight, height, sex), biological data (creatinine, urea, AST, ALT, albumin, PR, VGM, PAL, CDT, GGT), and tobacco consumption (number of cigarettes and Fagerstrom test). Pharmacokinetic analysis was performed by using a nonlinear mixed-effect population model (NONMEM 7.2 software). Data were modeled with a 1-compartment pharmacokinetic model. The population typical mean (95% confidence interval [95% CI]) values for clearance (CL), apparent volume of distribution (V), and rate constant of absorption (Ka) were 9.9 l/h (9.0 to 11.1), 80.7 l (63.6 to 96.9), and 4.6/h (1.5 to 19.9), respectively. The interindividual variability of CL (95% CI) and V (95% CI), and residual variability (95% CI) were 56.0% (47.9 to 60.7), 68.3% (48.7 to 80.1), and 0.096 mg/l (0.079 to 0.107), respectively. Baclofen exhibited a linear pharmacokinetics with a proportional relationship from 30 to 240 mg per day, the dose range currently used in alcoholic patients. A wide interpatient variability was observed which could not be explained by the covariates. This high variation of baclofen exposure may explain the lack of response observed for some patients.

Journal Europeen Des Urgences, Jun 1, 2005

... Minguet, Geneviève Mocquet, Jean-Marc Philippe, Patrick Plassais, Olivier Roquet, Dominique S... more ... Minguet, Geneviève Mocquet, Jean-Marc Philippe, Patrick Plassais, Olivier Roquet, Dominique Santallier, Nicolas Simon, Frédérik Staikowsky, Bertrand Yersin, Xavier Zarka, Quitterie Trevoux,Sandrine Galiegue. ... Les liaisons fortes du SU sont identifiées avant sa conception. ...

Journal Européen des Urgences, 2005

Emergency Medicine Journal, 2011

To determine which measures, other than a reduction in waiting time, could prevent the departure ... more To determine which measures, other than a reduction in waiting time, could prevent the departure of the left-without-being-seen (LWBS) patients in an emergency department. Secondary objectives were description of the characteristics of LWBS patients, analysis of their reasons for leaving and assessment of their medical outcome. A feasibility study was used to establish a telephone survey form. A prospective study of 421 patients was then carried out between 23 November 2006 and 12 February 2007 in the Poissy emergency department. Every LWBS patient whose telephone number was available in the administrative file was included. Patients who could not be contacted within 7 days after their departure were excluded. Statistical analyses were performed using STATA 8.0 software. 12,702 patients were admitted to the emergency department, of whom 421 (3.3%) (95% CI 0.030 to 0.036) left without being seen by a physician. 229 patients (54%) agreed to respond to the survey. 56% of the LWBS patients informed the medical team that they were leaving the emergency department. 74% of the surveyed participants suggested measures that could have helped them wait longer. These measures can be separated into two main categories: an improvement in communication and an improvement in the comfort of the emergency department waiting room. The 'quality' of the waiting time appears to be important in the decision to leave. If this aspect was taken into account, a reduction in the number of LWBS patients and improved quality of care could be achieved in emergency departments.

Anesthesia & Analgesia, 1996