Bulletin De L Academie Nationale De Medecine最新文献

{"title":"Le traitement de la migraine chez l’adulte","authors":"Anne Ducros ,&nbsp;Cédric Gollion ,&nbsp;Caroline Roos ,&nbsp;Lou Grangeon","doi":"10.1016/j.banm.2026.01.017","DOIUrl":"10.1016/j.banm.2026.01.017","url":null,"abstract":"<div><div>Migraine is a debilitating neurological condition which treatment combines an acute therapy for all patients, a preventive therapy for patients with multiple monthly migraines, lifestyle and dietary measures promoting regular physiological rhythms, and management of any comorbidities, particularly depression. Traditional oral treatments remain widely used and recommended as first-line options, including nonsteroidal anti-inflammatory drugs and triptans for acute attacks, and classic beta-blockers, antiepileptics, or antidepressants for prophylaxis. These conventional preventive treatments have limited efficacy and common adverse effects, leading to their discontinuation. Fortunately, the last decade has seen a therapeutic revolution in migraine management. CGRP-targeting antibodies and gepants offer migraine sufferers highly effective, well-tolerated, and customizable options, addressing the limitations of traditional treatments. Despite these advances, many patients still must insist on being taken seriously. In France, only 15% of migraine sufferers receive satisfactory management and highly effective therapies directly targeting the CGRP pathway (antibodies and gepants) are still not reimbursed.</div></div>","PeriodicalId":55317,"journal":{"name":"Bulletin De L Academie Nationale De Medecine","volume":"210 4","pages":"Pages 468-473"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discussion à propos de la communication : « Lupus cutané, dépression et anxiété »","authors":"Isabelle Jalenques","doi":"10.1016/j.banm.2026.03.003","DOIUrl":"10.1016/j.banm.2026.03.003","url":null,"abstract":"","PeriodicalId":55317,"journal":{"name":"Bulletin De L Academie Nationale De Medecine","volume":"210 4","pages":"Page 524"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lésions focales du cartilage articulaire : possibilités thérapeutiques actuelles et perspectives","authors":"Didier Mainard","doi":"10.1016/j.banm.2026.02.008","DOIUrl":"10.1016/j.banm.2026.02.008","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Le cartilage, tissu conjonctif spécialisé d’origine mésenchymateuse qui recouvre les extrémités osseuses au niveau des articulations a des propriétés biomécaniques remarquables qui assurent un parfait glissement des surfaces articulaires sous des contraintes majeures. Ces propriétés biomécaniques sont liées à l’hydrophilie spécifique des protéoglycanes de la matrice extracellulaire. Une des particularités de ce tissu est qu’il ne se restaure pas lorsqu’il est lésé, la cicatrisation évoluant vers un tissu fibreux ou fibrocartilagineux sans valeur fonctionnelle, source potentielle de dégénérescence arthrosique. Le cartilage peut présenter différents types lésionnels : les lésions sans perte de substance, avec perte de substance cartilagineuse, les lésions ostéochondrales. Chacune d’entre elles évolue de façon particulière. La stratégique thérapeutique face à une lésion chondrale ou ostéochondrale varie en fonction de nombreux critères. Les techniques de stimulation de l’os sous-chondral qui favorisent un blastème de régénération qui évoluera vers une métaplasie chondroïde, sont faciles à mettre en œuvre. Le forage de type Pridie est maintenant remplacé par les techniques de microfractures moins agressives réalisables sous arthroscopie. La refixation ostéochondrale doit être privilégiée lorsqu’elle est possible. Les autogreffes ostéochondrales en mosaïque amènent un tissu cartilagineux correspondant à l’unité fonctionnelle cartilage–os sous-chondral en lieu et place de la lésion au prix d’une morbidité modérée. Cependant il n’y a pas d’intégration véritable entre le cartilage périphérique et celui de l’autogreffe. Les allogreffes ostéochondrales sont d’utilisation marginale. La thérapie cellulaire par transplantation de chondrocyte ou de cellules souches a connu diverses évolutions techniques. Sa mise en œuvre est conditionnée par l’accès à un laboratoire capable de traiter la biopsie cartilagineuse et d’effectuer les cultures tri-dimensionnelles sur un support matriciel ou au sein d’une matrice macromoléculaire. Ces techniques de bio-ingénierie, à ce jour ne permettent pas encore d’obtenir une réparation cartilagineuse ad integrum malgré de multiples recherches expérimentales qui sont pourtant prometteuses. Elles restent néanmoins les voies thérapeutiques les plus intéressantes pour l’avenir. Enfin, au rebours des traitements biologiques, le remplacement de la perte de substance par un bouton prothétique métallique connaît un développement tout à fait limité.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;The cartilage is a specialized connective tissue of mesenchymal origin, which covers the extremities of the bones at the joint level. The cartilage has a fundamental biomechanical function, which ensures a perfect sliding of the joint surfaces, even under heavy load. These biomechanical properties are linked to the very particular hydrophilic properties of the proteoglycans in the extracellular matrix. The cartilage has a specific characteristic that it does not ","PeriodicalId":55317,"journal":{"name":"Bulletin De L Academie Nationale De Medecine","volume":"210 4","pages":"Pages 499-504"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communiqué. L’exigence d’une évaluation objective des pratiques de soins non conventionnelles","authors":"Académie nationale de médecine","doi":"10.1016/j.banm.2026.03.010","DOIUrl":"10.1016/j.banm.2026.03.010","url":null,"abstract":"","PeriodicalId":55317,"journal":{"name":"Bulletin De L Academie Nationale De Medecine","volume":"210 4","pages":"Page 396"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sommaire","authors":"","doi":"10.1016/S0001-4079(26)00129-9","DOIUrl":"10.1016/S0001-4079(26)00129-9","url":null,"abstract":"","PeriodicalId":55317,"journal":{"name":"Bulletin De L Academie Nationale De Medecine","volume":"210 4","pages":"Pages v-vi"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapport 26-02. L’entrée dans les études et l’attractivité des métiers de la pharmacie","authors":"Jean-Louis Beaudeux,&nbsp;Dominique Bertrand,&nbsp;groupe de travail « bi-académique » de l’Académie nationale de pharmacie et de l’Académie nationale de médecine","doi":"10.1016/j.banm.2026.03.005","DOIUrl":"10.1016/j.banm.2026.03.005","url":null,"abstract":"<div><div>Since the PASS/LAS health studies entry reform implemented in 2020, places have remained vacant in the second year of pharmacy studies. A lack of attractiveness has been observed due to the lack of awareness of the multiple professions in pharmacy, but a major cause appears to be the loss of visibility and lisibility of the access to the pharmacy course, which had already been noted during the implementation of a common first year in health studies (PACES) in 2010. The PASS/LAS scheme seemed too complex and ultimately ineffective in achieving the set objective of social diversification and training of students entering in health studies. The bi-academic working group aimed to precisely analyze the causes of the disaffection with pharmacy studies, through both a quantitative and qualitative analysis of entry into the pharmacy course. Nine recommendations for an improvement of the PASS/LAS system are proposed in this report, which should feed into the ongoing national reflection on a new reform of entry into health studies that is expected for the 2026–2027 academic year.</div></div>","PeriodicalId":55317,"journal":{"name":"Bulletin De L Academie Nationale De Medecine","volume":"210 4","pages":"Pages 376-385"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communiqué. Climat et santé en méditerranée","authors":"Académie nationale de médecine","doi":"10.1016/j.banm.2026.03.009","DOIUrl":"10.1016/j.banm.2026.03.009","url":null,"abstract":"","PeriodicalId":55317,"journal":{"name":"Bulletin De L Academie Nationale De Medecine","volume":"210 4","pages":"Page 395"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rôle de l’intelligence artificielle en recherche clinique : promesses, méthodologie d’évaluation et intégration opérationnelle","authors":"Loic Verlingue,&nbsp;Camille Brodin,&nbsp;Jean-Yves Blay","doi":"10.1016/j.banm.2025.12.028","DOIUrl":"10.1016/j.banm.2025.12.028","url":null,"abstract":"<div><div>The intense development of artificial intelligence applications opens up major opportunities for clinical research: by increasing the number of new treatments, improvement of their efficacy, accelerating of the identification of eligible patients, improvement of data quality, and optimization of trials (use of real-life data, innovative design). Some approaches incorporating digital tools support equitable access for patients to clinical trials, optimization of clinical infrastructure and health economics, main factors that may attract pharmaceutical companies in countries that have integrated these practices. However, the translation of technical performances into measurable clinical benefits remains limited and requires rigorous methodological frameworks (real-life evaluation, prospective, multicenter, randomized trials where relevant), as well as secure integration into health information systems. In addition, this requires training and interest of young doctors, so that they can adapt to the deep transformation expected and maintain a visible place in the global competition for access to new clinical trials, in order to provide optimal care of our patients. Based on recent experiences in oncology, we illustrate the evolution of our disciplines, placing ethics, patient safety and the efficiency of research circuits at the forefront.</div></div>","PeriodicalId":55317,"journal":{"name":"Bulletin De L Academie Nationale De Medecine","volume":"210 4","pages":"Pages 488-492"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications de l’intelligence artificielle à la découverte de nouveaux traitements contre les maladies auto-immunes","authors":"Philippe Moingeon","doi":"10.1016/j.banm.2026.01.021","DOIUrl":"10.1016/j.banm.2026.01.021","url":null,"abstract":"<div><div>Predictive models based on artificial intelligence (AI) are transforming the search for new treatments for complex chronic conditions such as Sjögren's disease or Systemic Lupus Erythematosus. Computational models of these autoimmune diseases are built from patient molecular profiling data obtained through multiomics technologies integrated by AI. These analyses help to represent patient heterogeneity and to identify relevant therapeutic targets among the molecular pathways dysregulated in these diseases. AI is also used to identify and optimize drug candidates that interact with these therapeutic targets, and to design combined therapies. Cohorts of virtual patients can be created to predict in silico the efficacy of drug candidates. By stratifying patients into molecularly defined subgroups — thus enabling optimized therapeutic options — AI is fostering a computational precision medicine that could ultimately link detailed individual patient characteristics with the predicted properties of billions of drug candidates with the aim to propose increasingly personalized treatments.</div></div>","PeriodicalId":55317,"journal":{"name":"Bulletin De L Academie Nationale De Medecine","volume":"210 4","pages":"Pages 493-498"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quelles conséquences pour la femme d’une réponse inflammatoire sexuée ?","authors":"Georges Casimir","doi":"10.1016/j.banm.2026.01.016","DOIUrl":"10.1016/j.banm.2026.01.016","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Les femmes présentent, tout au long de la vie, une meilleure survie que les hommes, phénomène observé dès la période néonatale. Si des facteurs comportementaux et environnementaux sont souvent invoqués, ils n’expliquent qu’une partie des différences observées. Les données épidémiologiques et expérimentales montrent de manière constante une immunoréactivité plus élevée chez les femelles, tant chez les humains que dans les modèles animaux, conduisant à une meilleure résistance aux agressions infectieuses aiguës. Les réponses inflammatoires — cellules innées, cytokines, anticorps — semblent plus rapides (mobilisation de départ et retour à l’équilibre) ou plus efficaces dans le sexe féminin, et pourraient contribuer à leur avantage pronostique lors d’infections sévères. Cette supériorité n’est toutefois pas universelle : dans les maladies inflammatoires chroniques, lorsque le processus inflammatoire persiste sans retour à l’homéostasie, les femmes présentent souvent un pronostic plus défavorable, comme observé dans l’asthme sévère, la mucoviscidose ou les connectivites. L’étude de cohortes pédiatriques prépubères montre déjà, avant toute influence hormonale marquée, des différences significatives de marqueurs inflammatoires selon le sexe, suggérant un rôle important des déterminants génétiques, notamment du chromosome X. Cependant ces pathologies chroniques sont beaucoup moins fréquentes que les aiguës et n’ont pas un effet de population déterminant sur l’espérance de vie, meilleure chez la femme. La mise au point discute les mécanismes potentiels — hormones sexuelles, facteurs génétiques, expression différentielle de gènes de l’immunité — et les implications cliniques pour la prise en charge des maladies aiguës et chroniques selon le sexe. Une meilleure compréhension de l’inflammation sexuée ouvre la voie à des stratégies thérapeutiques adaptées au sexe et à l’âge.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;Women have, throughout life, higher survival than men, a phenomenon already present in early childhood. Behavioural and environmental factors explain only part of this difference. Epidemiological and experimental data consistently show enhanced immunoreactivity in females, both in humans and animal models, leading to improved resistance to acute infectious insults. Inflammatory responses — including innate cells, cytokines and antibodies — appear to be faster or more effective in girls and women, contributing to their better prognostic outcomes during severe infections. This advantage is not universal: in chronic inflammatory diseases, when inflammation persists without return to homeostasis, females often experience a worse prognosis, as observed in severe asthma, cystic fibrosis or connective tissue disorders. Studies of prepubertal pediatric cohorts already reveal sex-related differences in inflammatory markers, before significant hormonal influence, suggesting an important role for genetic determinants, particularly X-chromosome–linked mechanisms. Obviou","PeriodicalId":55317,"journal":{"name":"Bulletin De L Academie Nationale De Medecine","volume":"210 4","pages":"Pages 505-509"},"PeriodicalIF":0.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}