La Presse Médicale Formation最新文献

{"title":"Développement durable au bloc opératoire : les impératifs","authors":"N. Néaume","doi":"10.1016/j.lpmfor.2026.100811","DOIUrl":"10.1016/j.lpmfor.2026.100811","url":null,"abstract":"<div><div>Dans un contexte d’urgence climatique, le secteur de la santé doit s’engager activement dans la réduction de son empreinte environnementale. Le bloc opératoire, en raison de la fréquence et de la standardisation croissante des procédures qui y sont réalisées, constitue un terrain stratégique pour expérimenter des pratiques écoresponsables. Cette mise au point propose une hiérarchisation des écogestes applicables à l’ensemble des activités opératoires, indépendamment de la spécialité chirurgicale. Elle inclut : l’utilisation préférentielle d’instruments réutilisables, l’optimisation des sets opératoires, la réduction des dispositifs à usage unique, la limitation des anesthésiques volatils les plus polluants – en particulier le desflurane (désormais interdit en Europe au 1^er janvier 2026) et le protoxyde d’azote –, la maîtrise de la consommation énergétique, ainsi qu’une gestion raisonnée des déchets et de la logistique. Elle souligne également le rôle clé de la formation, du pilotage institutionnel et de l’intégration de critères environnementaux dans les démarches qualité. Au-delà d’un enjeu éthique, la durabilité devient un critère de performance à part entière dans l’organisation des soins chirurgicaux.</div></div><div><div>In the context of the climate emergency, the healthcare sector must actively engage in reducing its environmental footprint. The operating theatre, given the frequency and increasing standardisation of the procedures performed there, represents a strategic setting in which to trial eco-responsible practices. This review proposes a prioritised framework of green initiatives applicable to all surgical activities, regardless of the surgical specialty involved. It encompasses: the preferential use of reusable instruments, the optimisation of surgical sets, the reduction of single-use devices, the limitation of the most polluting volatile anaesthetics – in particular desflurane (now banned in Europe as of 1st January 2026) and nitrous oxide –, the management of energy consumption, and a reasoned approach to waste management and logistics. It also highlights the key role of training, institutional governance, and the integration of environmental criteria into quality improvement processes. Beyond an ethical imperative, sustainability is becoming a performance criterion in its own right in the organisation of surgical care.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"7 3","pages":"Article 100811"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148822628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception et diabète","authors":"Iphigénie Cavadias,&nbsp;Ryma Bessa,&nbsp;Geneviève Plu-Bureau","doi":"10.1016/j.lpmfor.2026.100819","DOIUrl":"10.1016/j.lpmfor.2026.100819","url":null,"abstract":"<div><div>Plus de 4 millions de personnes sont traitées pour un diabète en France et 45 % d’entre elles sont des femmes.</div><div>Compte tenu des risques majorés de complications maternelles et fœtales en cas de grossesse chez les femmes diabétiques, la planification d’une éventuelle grossesse est un enjeu majeur de la prise en charge gynécologique de ces patientes.</div><div>Les contraceptifs hormonaux, estroprogestatifs ou progestatifs seuls, ne semblent pas augmenter le risque de diabète d’après de larges données épidémiologiques.</div><div>Les contraceptions estroprogestatives et progestatives seules ne modifient pas l’équilibre glycémique chez les femmes diabétiques.</div><div>Les contraceptions de choix en 1^re intention sont le DIU au cuivre, le DIU au lévonorgestrel, les pilules microprogestatives et l’implant sous-cutané à l’étonogestrel.</div><div>Les contraceptions estroprogestatives peuvent être utilisées chez les femmes diabétiques jeunes avec un diabète de moins de 20 ans sans complication micro ni macro-angiopathique et sans autre facteur de risque artériel ou veineux.</div></div><div><div>Over 4 million people are treated for diabetes in France, and 45% of them are women.</div><div>Given the increased risk of maternal and foetal complications, it is essential to plan for any potential pregnancy and to offer appropriate contraception to all diabetic women at risk of pregnancy.</div><div>Combined oral contraceptive or progestin-only contraceptive do not appear to increase the risk of diabetes, according to extensive epidemiological data.</div><div>Combined oral contraceptive or progestin-only contraceptive do not alter glycemic balance in diabetic women.</div><div>The first-line contraceptives are the copper IUD, the levonorgestrel IUD, the progestin-only pills and the etonogestrel implant.</div><div>Combined oral contraceptive can be used in young diabetic women with diabetes for less than 20<!--> <!-->years, without micro or macro-angiopathic complications and without any other arterial or venous risk factors.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"7 3","pages":"Article 100819"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148822617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Le diabète gestationnel en 2026","authors":"Alice Gilly,&nbsp;Laure Toledano,&nbsp;Brigitte Raccah-Tebeka","doi":"10.1016/j.lpmfor.2026.100820","DOIUrl":"10.1016/j.lpmfor.2026.100820","url":null,"abstract":"<div><div>Le diabète gestationnel est une pathologie fréquente et en augmentation constante touchant environ actuellement 10 % des femmes enceintes.</div><div>Le diabète gestationnel augmente le risque de complications obstétricales et néonatales.</div><div>Les recommandations du dépistage ciblent les populations à risque.</div><div>Les objectifs glycémiques sont stricts et doivent être vérifiés par une auto-surveillance régulière : glycémie à jeun<!--> <!-->&lt;<!--> <!-->0,95<!--> <!-->g/L et post-prandiale<!--> <!-->&lt;<!--> <!-->1,20<!--> <!-->g/L à 2<!--> <!-->heures.</div><div>Le traitement impose avant tout des règles hygiénodiététiques avec un passage à l’insulinothérapie en cas de non-respect des objectifs glycémiques.</div><div>Le diabète gestationnel constitue un facteur de risque établi de survenue ultérieure d’évènements cardio-vasculaires.</div></div><div><div>Gestational diabetes is a common condition with a steadily increasing prevalence, currently affecting approximately 10% of pregnant women.</div><div>Gestational diabetes increases the risk of obstetric and neonatal complications.</div><div>Screening recommendations target high-risk populations.</div><div>Glycemic targets are strict and must be monitored through self-monitoring of blood glucose: fasting glucose<!--> <!-->&lt;<!--> <!-->0.95<!--> <!-->g/L and postprandial blood glucose<!--> <!-->&lt;<!--> <!-->1.20<!--> <!-->g/L at 2<!--> <!-->hours.</div><div>Management primarily involves lifestyle and dietary changes, with initiation of insulin therapy if glycemic targets are not achieved.</div><div>Gestational diabetes is an established risk factor for subsequent cardiovascular risk.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"7 3","pages":"Article 100820"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148822618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Algorithme de prise en charge de la douleur thoracique aiguë spontanée","authors":"Hubert Dromas,&nbsp;Gilles Lemesle","doi":"10.1016/j.lpmfor.2026.100815","DOIUrl":"10.1016/j.lpmfor.2026.100815","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"7 3","pages":"Article 100815"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148822622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Le HDL n’est plus le « bon cholestérol » !","authors":"J.-F. Renucci,&nbsp;J. Bertolino,&nbsp;G. Sarlon","doi":"10.1016/j.lpmfor.2026.100814","DOIUrl":"10.1016/j.lpmfor.2026.100814","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"7 3","pages":"Article 100814"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148822621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dépistage du cancer du col utérin","authors":"Ryma Bessa,&nbsp;Hillary Juillet,&nbsp;Lucie Laot,&nbsp;Geneviève Plu-Bureau","doi":"10.1016/j.lpmfor.2026.100816","DOIUrl":"10.1016/j.lpmfor.2026.100816","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"7 3","pages":"Article 100816"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148822623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sommaire","authors":"","doi":"10.1016/S2666-4798(26)00069-8","DOIUrl":"10.1016/S2666-4798(26)00069-8","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"7 3","pages":"Article 100827"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148822624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La cindynique appliquée en néphrologie","authors":"E. Nnang Obada","doi":"10.1016/j.lpmfor.2026.100812","DOIUrl":"10.1016/j.lpmfor.2026.100812","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"7 3","pages":"Article 100812"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148822627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Éditorial","authors":"Geneviève Plu-Bureau","doi":"10.1016/j.lpmfor.2026.100818","DOIUrl":"10.1016/j.lpmfor.2026.100818","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"7 3","pages":"Article 100818"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148822629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabète et ménopause","authors":"Sandrine Kretz,&nbsp;Sandrine Perol","doi":"10.1016/j.lpmfor.2026.100821","DOIUrl":"10.1016/j.lpmfor.2026.100821","url":null,"abstract":"<div><div>En 2023, en France, 14 millions de femmes sont ménopausées dont plus d’un million de femmes sont diabétiques.</div><div>L’impact du statut ménopausique sur le risque de développer un diabète, malgré un effet péjoratif sur les paramètres glucidiques, reste discuté, les études étant contradictoires.</div><div>Une vie génitale courte est associée à un risque de diabète de type 2 chez les femmes ménopausées, en particulier pour celles avec une insuffisance ovarienne prématurée et/ou ménopause avancée.</div><div>L’impact du diabète sur l’âge de survenue de la ménopause, montre une tendance à un âge plus précoce lorsque le diabète survient tôt dans la vie.</div><div>Une approche individualisée, en tenant compte de l’ensemble des facteurs de risque cardiovasculaires, doit donc être envisagée chez les patientes diabétiques avant d’envisager la prescription d’un THM.</div></div><div><div>In 2023, 14 millions of French women will be menopausal, more than 1 million women with diabetes.</div><div>The impact of menopausal status on the risk of developing diabetes remains debated, despite a worsening effect on glycemic parameters, with studies showing contradictory results.</div><div>A shorter reproductive lifespan is associated with a higher risk of type 2 diabetes in postmenopausal women, particularly in those with premature ovarian failure and/or advanced menopause.</div><div>The impact of diabetes on the age of onset of menopause shows a tendency toward an earlier age when diabetes occurs early in life.</div><div>An individualized approach, taking into account all cardiovascular risk factors, should therefore be considered in diabetic women before prescribing HT.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"7 3","pages":"Article 100821"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148822619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}