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OBJECTIVES:A daily assessment of the speed of action and effectiveness of treatment of a combination of paracetamol and codeine in patients suffering from intense pain, which has progressed since less than 7 days. METHODS: A multicentre longitudinal observational prospective study carried out in metropolitan France using data collected by general practitioners who agreed to participate. RESULTS: A total of 574 patients treated by a paracetamol-codeine combination (600mg/50mg and 400mg/20mg) were included. The severity of pain measured at inclusion using a visual numeric scale was 7Ϯ1.28. The severity of pain measured after half a day of treatment was 5.61Ϯ1.87 and 5.28 Ϯ 1.86 at the end of the first 24 hours of treatment. A significant improvement in pain was observed from the first half-day (pϽ0.001). The severity of pain on the 2nd, 4th and 7th evenings was respectively 4.08Ϯ1.85; 2.76Ϯ1.76 and 1.79 Ϯ1.69 On D1, 69.7% declared treatment to be effective, 61.04% were satisfied with their treatment and 79.26% did not observe any side effects to the treatment. On D7, 96.15% (D3, 91.3% ) declared treatment to be effective, 87.10% were satisfied with their treatment and 88.96% did not observe any side effects to the treatment. 8 out of 10 patients did not complain about side effects related to the treatment. CONCLUSIONS: A reduction in pain within the first 12 hours showed the pertinence of treatment using a paracetamol-codeine combination. This pertinence was confirmed by two-thirds patients who declared the treatment to be effective from the 1st day, and 91% of them declared this on the 3rd day

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Objectives: The study was performed to investigate the changes of urinary thiodiglycolic acid (TDGA) concentration in workers exposed to vinyl chloride monomer (VCM) according to the time of sampling urine. Methods: The personal exposure to airborne VCM was assessed and urinary TDGA concentration was sampled in 31 workers employed in a VCM and polyvinyl chloride (PVC) manufacturing factory. Urinary TDGA was sampled three times: before the start of the shift after 3 days off (TDGA1), after the end of the first-day shift (TDGA2) and before starting the following day shift after completing the oneday shift (TDGA3). Urinary TDGA in 30 workers who had not been exposed to airborne VCM was sampled after the end of the shift. A gas chromatography/pulsed flame photometric detector (GC/PFPD) was utilized to analyze TDGA concentration in urine after the urine was methylated with trimethylsilyldiazomethane (2.0M in diethyl ether). Results: The creatinine level was 0.179±0.271 mg/g in the control workers and 0.218±0.443 mg/g in the workers before the start of the shift after 3 days off (TDGA1), showing no significant difference (p=0.7035). Urine samples were compared according to sampling time in order to investigate the change of urinary TDGA concentration in the case of continuous exposure to airborne VCM. In VCM-exposed workers, urinary creatinine concentration was 0.434±0.623 mg/g in TDGA2 and 0.767±1.056 mg/g in TDGA3, which indicated a gradual but significant increase (p=0.024). In terms of the statistical correlation between airborne VCM and urinary TDGA to evaluate exposure dose per day, of the three urinary TDGA concentrations, TDGA3 showed the highest degree of regression (R 2 =0.4215) with 8h-TWA airborne VCM concentration. Conclusion: Based on this result, the excretion half-life of urinary TDGA was assumed to be less than 3 days, because the concentration of urinary TDGA at 3 days after exposure to airborne VCM was decreased to the level of urinary TDGA concentration in the control workers. The concentration of uri