La Presse Médicale Formation最新文献

{"title":"La réduction des risques et des dommages appliquée aux pratiques de soins non conventionnelles : analyse des usages à risques et questionnaire d’évaluation des risques","authors":"Fabrice Berna ,&nbsp;Julien Nizard ,&nbsp;Laurence Verneuil ,&nbsp;François Paille","doi":"10.1016/j.lpmfor.2023.11.004","DOIUrl":"10.1016/j.lpmfor.2023.11.004","url":null,"abstract":"<div><p>Les pratiques de soins dites non conventionnelles (PSNC) sont fréquemment utilisées par la population générale, tout particulièrement par les patients ayant un cancer.</p><p>Certaines PSNC comportent des risques pour la santé, du fait de dérives thérapeutique ou parfois sectaire.</p><p>Différents facteurs influencent ce risque : le type de thérapie, son contexte d’utilisation, la pathologie concernée par la thérapie, la qualification, la formation et l’éthique du praticien.</p><p>La stratégie de réduction des risques et des dommages (RDRD) a été utilisée en addictologie pour réduire les comportements thérapeutiques à risque tout en acceptant les choix des usagers.</p><p>La RDRD est une stratégie pragmatique et non dogmatique qui nous paraît pertinente pour améliorer l’encadrement et la réglementation des PSNC.</p><p>La médecine intégrative offre un modèle concret de RDRD permettant aux patients un accès aux PSNC disposant de garanties en termes de sécurité.</p><p>Définir les PSNC comme « à risque » ou à établir une liste de « PSNC à risque » comporte des simplifications en décalage avec la variété d’usages des PSNC.</p></div><div><p>Unconventional healthcare practices (UCHPs) are frequently used in the general population, particularly in patients with cancer.</p><p>Certain uses of UCHPs entail a risk to health, of therapeutic aberrations and even sectarian aberrations.</p><p>Various factors influence this risk: the type of therapy, the context in which it is used, the pathology concerned by the therapy, and the practitioner's diploma, training and ethics.</p><p>The harm-reduction strategy (HRS) has been used in addictology to reduce risky treatments, while accepting users’ choices.</p><p>HRS is a pragmatic, non-dogmatic strategy that is relevant to improve the regulation of UCHPs.</p><p>Integrative medicine provides a realistic model of HRS by offering to patients a safe access to UCHP.</p><p>Defining UCHP as “risky” or making a list of “risky UCHP” entails oversimplifications that do not correspond to the variety of UCHP uses.</p></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 1","pages":"Pages 10-20"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018854","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":"Pathologies proctologiques : ne pas négliger !","authors":"Béatrice Vinson Bonnet","doi":"10.1016/j.lpmfor.2024.01.005","DOIUrl":"10.1016/j.lpmfor.2024.01.005","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 1","pages":"Pages 22-23"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139639319","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":"Recommandations européennes sur la prise en charge cardiovasculaire des patients diabétiques : des changements majeurs","authors":"Emilie Merlen","doi":"10.1016/j.lpmfor.2024.01.001","DOIUrl":"10.1016/j.lpmfor.2024.01.001","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 1","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139453967","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":"Faut-il éviter les bloqueurs du système rénine-angiotensine en cas de sténose athéromateuse de l’artère rénale ?","authors":"Valentin Maisons ,&nbsp;Bénédicte Sautenet","doi":"10.1016/j.lpmfor.2024.01.004","DOIUrl":"10.1016/j.lpmfor.2024.01.004","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 1","pages":"Pages 67-69"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666479824000041/pdfft?md5=5752d1ab7bc7be01efa606dbff0a00b5&pid=1-s2.0-S2666479824000041-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139537857","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":"Pathologies proctologiques au cours de la grossesse et en post-partum (hors MICI)","authors":"Charlotte Favreau","doi":"10.1016/j.lpmfor.2024.01.008","DOIUrl":"10.1016/j.lpmfor.2024.01.008","url":null,"abstract":"<div><p>Une femme enceinte sur trois présente des troubles proctologiques au cours de la grossesse et du post-partum.</p><p>La constipation est souvent de mise, facteur de risque pour d’autres pathologies.</p><p>La fissure anale est la lésion la plus fréquemment rencontrée dans le post-partum.</p><p>La thrombose hémorroïdaire externe est également fréquente, souvent trop œdémateuse pour permettre un geste d’incision.</p><p>Les traumatismes obstétricaux peuvent altérer la continence anale, ils ne sont pas toujours évitables et doivent faire l’objet d’une prise en charge spécialisée.</p><p>Il est exceptionnel de devoir opérer en urgence une femme enceinte pour un problème proctologique.</p></div><div><p>One in three pregnant women present proctological disorders during pregnancy or after delivery.</p><p>Constipation is often present; it is a risk factor for proctological pathologies.</p><p>Anal fissure is the most frequent proctological problem during pregnancy and after delivery.</p><p>External hemorrhoidal thrombosis is common, often too edematous to allow an incision procedure.</p><p>Obstetric trauma can impair anal continence; it is not always preventable and must be the subject of specialized care.</p></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 1","pages":"Pages 62-66"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632050","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":"Souris péritonéale : une image d’appendice épiploïque libre","authors":"C. Abourak,&nbsp;S. Oukassem,&nbsp;A. Guennouni,&nbsp;F.Z. Laamrani,&nbsp;L. Jroundi,&nbsp;O. El Aoufir","doi":"10.1016/j.lpmfor.2023.11.002","DOIUrl":"10.1016/j.lpmfor.2023.11.002","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 1","pages":"Pages 92-93"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138624221","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":"L’esprit d’Hippocrate","authors":"Patrick Berche","doi":"10.1016/j.lpmfor.2023.10.027","DOIUrl":"10.1016/j.lpmfor.2023.10.027","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 1","pages":"Pages 74-81"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138991536","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":"Prise en charge d’une première crise épileptique chez l’adulte","authors":"Stanislas Lagarde ,&nbsp;Fabrice Bartolomei","doi":"10.1016/j.lpmfor.2024.01.002","DOIUrl":"10.1016/j.lpmfor.2024.01.002","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 1","pages":"Pages 70-73"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666479824000028/pdfft?md5=7c79f5c14c0af3fbb12e483f72e503bf&pid=1-s2.0-S2666479824000028-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139455820","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":"SIGAPS, un système dévoyé pour évaluer la recherche en santé","authors":"Bruno Riou ,&nbsp;Christian Funck-Brentano ,&nbsp;Thomas Similowski ,&nbsp;Pierre Corvol","doi":"10.1016/j.lpmfor.2024.01.010","DOIUrl":"10.1016/j.lpmfor.2024.01.010","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 1","pages":"Pages 3-4"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666479824000107/pdfft?md5=b1e4f557b3c0eb789e6d462f388de0c5&pid=1-s2.0-S2666479824000107-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139539287","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":"Quand et comment traiter des hémorroïdes","authors":"Thierry Higuero","doi":"10.1016/j.lpmfor.2024.01.003","DOIUrl":"10.1016/j.lpmfor.2024.01.003","url":null,"abstract":"<div><p>En cas de maladie hémorroïdaire, on ne traite que les patients qui s’en plaignent.</p><p>Le traitement dépend de la présentation anatomique et des attentes du patient.</p><p>Le traitement médical associant une régularisation du transit, des topiques, et éventuellement des veinotoniques et des antalgiques doit être proposé en première intention pour les grades 1 à 3.</p><p>En cas d’échec, il faut confier le patient au proctologue pour un traitement instrumental qui sera le plus souvent une photocoagulation infrarouge ou une ligature élastique.</p><p>En situation d’échec ou en cas de prolapsus de grade 4, la chirurgie par hémorroïdectomie pédiculaire est le traitement le plus efficace à long terme.</p><p>Les techniques chirurgicales mini invasives ne traitent efficacement que les prolapsus de grade 2 et 3, sont déconseillés en cas de grade 4 et ne fonctionnent pas en cas de maladie hémorroïdaire externe.</p><p>Le choix de la technique opératoire est fait par le chirurgien proctologue en tenant compte des attentes du patient.</p></div><div><p>In the event of haemorrhoidal disease, only symptomatic patients are treated.</p><p>Treatment depends on the anatomical presentation and the patient's expectations.</p><p>First line treatment for grade 1 to 3 haemorrhoids, combines bowel movement regularization, topical treatment and possibly phlebotonics and analgesic.</p><p>In case of failure, the patient has to be referred to the proctologist for an ambulatory procedure that will most commonly be an infrared photocoagulation or a rubber band ligation.</p><p>In case of failure or for grade 4 haemorrhoids, hemorrhoidectomy is the standard of care with the most effective long-term results.</p><p>Minimally invasive surgical techniques only effectively treat grade 2 and 3 prolapses, are not recommended in grade 4 and do not work in case of external hemorrhoidal disease.</p><p>The choice of surgical procedure is made by the proctologist surgeon taking into account the patient's expectations.</p></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 1","pages":"Pages 24-30"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139634648","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}