{"title":"[Patient, illness, person: words for thinking about and organising care].","authors":"Cédric Lemogne, Patrice Marvanne, Catherine Vergely, Marie-France Mamzer","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"363-364"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369974","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":"[The place of ethnic origin in research].","authors":"Philippe Charlier","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"379-380"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369984","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":"[Severe dysmenorrhea and endometriosis].","authors":"Éric Bautrant, Chloé Lacoste, Delphine Lhuillery","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>SEVERE DYSMENORRHEA AND ENDOMETRIOSIS. Severe dysmenorrhoea, or grade 3 dysmenorrhoea according to the Andersch and Millson classification, is present in the vast majority of patients suffering from endometriosis from the first menstrual period. Numerous studies confirm that young girls with severe dysmenorrhoea are in a situation of central hypersensitivity, which is probably at the origin of chronic pelvic pain and co-morbidities. Many authors consider severe dysmenorrhoea to be a precursor of endometriosis. Controlling primary severe dysmenorrhoea therefore appears to be one of the major focus in the management of pelvic pain and the prevention of endometriosis. While endometriosis lesions can aggravate the clinical picture of pain, they rarely explain neuropathic pain. Compressions of nerve trunks by endometriosis nodules are rare. However, neuropathic pain, of the nociplastic type, as part of patients' central hypersensitivity, is common. Treatment is multi-modal. Hormonal treatments are not only control endometriosis lesions, but also chronic pain. By inducing amenorrhoea, the repeated nociceptive influxes of severe dysmenorrhoea can be suppressed, and central hypersensitivity during the menstrual period can be prevented from worsening. Treatment of severe dysmenorrhoea or attacks can benefit from level 1 or 2 analgesics. However, level 3 should never be prescribed in this indication. In the case of chronic pain, a background treatment is proposed. This involves anti-depressants that act on central sensitisation or anti-epileptics. Physiotherapy, TENS (Transcutaneous Electrical Nerve Stimulator) and cognitive-behavioural therapies are part of the multimodal first-line treatment. The indications for surgery and second- or third-line treatments, such as uterine botulinum toxin injections under hysteroscopy, salbutamol or CBD, are discussed.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"425-431"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369983","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}
Julien Nizard, François Paille, Laurence Verneuil, Fabrice Berna
{"title":"[Principles of integrative medicine, usefulness and risks of nondrug interventions and complementary therapies].","authors":"Julien Nizard, François Paille, Laurence Verneuil, Fabrice Berna","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 3","pages":"333-339"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369957","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":"[Toxicological aspects of chemical submission].","authors":"Pascal Kintz, Adeline Blanchot, Audrey Farrugia, Jean-Pierre Goullé","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>TOXICOLOGICAL ASPECTS OF CHEMICAL SUBMISSION. According to the French law (article 222-15 modifié par la loi n° 2007-297 du 5 mars 2007), a drug-facilitated crime is defined as voluntary administration to a subject of a noxious substance with a mental or a physical effect. Victims can be highly variable, from very young children to very old people irrespective of their social status. As several practitioners (general physicians, emergency doctors, gynecologists, forensic pathologists, police forces) can be involved during the initial claims, it is often complicated to get a suitable reception after an assault. Indeed, drug-facilitated crimes not only involve sexual assaults, but also robberies with trick, workplace or sport competitions or any situation where the sedation of somebody is required (childcare, old people care homes). The most frequent active substances found in these cases include sedative pharmaceuticals (hypnotics, benzodiazepines, anti-histaminic compounds, neuroleptics) and entactogens (ecstasy, synthetic cathinones). Often, the victim's claims are too late to collect blood or urine, and therefore hair tests constitute the best approach to document drug exposure, which is mandatory during trials at criminal courts.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 3","pages":"316-320"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369961","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}
Sophie Larger, Charlotte Jacquemot, Lisa Friedlander
{"title":"[Chaire Vulca, transdisciplinarity at the service of patients].","authors":"Sophie Larger, Charlotte Jacquemot, Lisa Friedlander","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 3","pages":"247-249"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369938","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":"[Management of bleeding with hormonal contraception].","authors":"Naima Hamdaoui","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>MANAGEMENT OF BLEEDING WITH HORMONAL CONTRACEPTION, Explaining contraception side effects chosen by a woman, in particular spotting with progestin contraception, would allow for better compliance. Unscheduled bleeding with hormonal contraception need to search of an organic etiology, a drug interaction, infection. A pregnancy must be excluded in the event of poor compliance or clinical suspicion. Persistence of bleeding with 20 _g ethinylestradiol combined oral contraception could be improved by an increase in the dosage. In addition, a change in the type of progestin (switch 2nd to 3rd generation) seems to improve the bleeding profile. Many treatments have been evaluated with an impact of bleeding profile, but due to the heterogeneity of the studies, the data are inconclusive. It appears that tranexamic acid and nonsteroidal anti-inflammatory drugs improve the bleeding profile under etonogestrel subcutaneous contraceptive implant but only transiently. The combination with estrogens does not show any improvement, particularly with the levonorgestrel intrauterine system. Other treatments have been evaluated such as doxycycline or mifepristone with relatively good results in improving bleeding.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 3","pages":"303-305"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369953","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}