La Presse Médicale Formation最新文献

{"title":"Diagnostique étiologique et traitement de l’hyponatrémie","authors":"Jérémy Zaworski , François Vrtovsnik","doi":"10.1016/j.lpmfor.2025.100600","DOIUrl":"10.1016/j.lpmfor.2025.100600","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 1","pages":"Article 100600"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552467","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":"Violences Educatives Ordinaires (VEO) : de quoi parle-t-on ?","authors":"Camille Lorette , Gilles Lazimi","doi":"10.1016/j.lpmfor.2025.100595","DOIUrl":"10.1016/j.lpmfor.2025.100595","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"6 1","pages":"Article 100595"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552462","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":"TDAH : attention aux comorbidités !","authors":"Hugo Zoppé ,&nbsp;Sébastien Weibel","doi":"10.1016/j.lpmfor.2024.09.003","DOIUrl":"10.1016/j.lpmfor.2024.09.003","url":null,"abstract":"<div><div>– Les comorbidités psychiatriques et les affections médicales générales sont particulièrement fréquentes à la fois chez les enfants et les adultes ayant un TDAH.</div><div>– Plus que la question du diagnostic différentiel, il est important d’avoir une compréhension de l’interaction entre le TDAH et ses comorbidités, notamment dans une perspective développementale.</div><div>– Le TDAH a des facteurs étiologiques communs avec les autres troubles du neurodéveloppement (notamment trouble du spectre de l’autisme et troubles des apprentissages) et certains troubles psychiatriques (trouble bipolaire, troubles addictifs).</div><div>– Le TDAH est un facteur de risque pour le développement de différents troubles psychiatriques, du fait du profil cognitif particulier (par exemple forte impulsivité), mais aussi du fait des conséquences du retentissement du TDAH en termes de développement affectif et d’événements de vie (troubles oppositionnels, de la personnalité, troubles anxieux, troubles de l’humeur).</div><div>– L’accompagnement optimal d’une personne avec TDAH devra inclure une identification et une prise en charge systématique de ces comorbidités.</div></div><div><div>– Comorbid psychiatric disorders and general medical conditions are highly prevalent among both children/adolescents with ADHD and adults with ADHD.</div><div>– In addition to the issue of a possible differential diagnosis, the most important point relies on the careful understanding of the interaction between ADHD and its comorbidities, especially by relying on a developmental perspective.</div><div>– ADHD shares some etiological risk factors with the other neurodevelopmental disorders (especially autism spectrum disorder and learning disorders) and with some psychiatric disorders (especially bipolar disorder and addictive disorders).</div><div>– ADHD is a risk factor for subsequent or comorbid psychiatric disorders. This may be explained by a specific cognitive profile (e.g., high impulsivity), but also by the negative consequences ADHD may have in terms of affective development and negative life events (e.g., oppositional defiant disorder, personality disorders, anxiety disorders, mood disorders).</div><div>– The optimal management of an individual with ADHD should systematically include the adequate screening, identification and management of the associated psychiatric disorders and general medical conditions.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 6","pages":"Pages 408-416"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656651","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":"CV1 / Sommaire","authors":"","doi":"10.1016/S2666-4798(24)00176-9","DOIUrl":"10.1016/S2666-4798(24)00176-9","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 6","pages":"Page CO1"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656778","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 médicamenteuse du TDAH : prescrire, c’est guérir ?","authors":"Louise Carton ,&nbsp;Laura Parigny ,&nbsp;May Boumendjel ,&nbsp;Olivier Ménard ,&nbsp;Stéphanie Bioulac ,&nbsp;Étienne Kammerer","doi":"10.1016/j.lpmfor.2024.09.006","DOIUrl":"10.1016/j.lpmfor.2024.09.006","url":null,"abstract":"<div><div>– La prise en charge pharmacologique du TDAH est à envisager en seconde intention, après échec des mesures non médicamenteuses.</div><div>– Le traitement médicamenteux de première ligne repose, en France, sur les spécialités à base de méthylphénidate.</div><div>– La guanfacine dispose également d’une AMM dans le TDAH de l’enfant et l’adolescent, mais est un traitement de dernière intention.</div><div>– Les autres médicaments disponibles en France et pouvant être utilisés dans le TDAH font soit l’objet d’une autorisation d’accès compassionnel (atomoxétine), soit sont hors AMM (clonidine).</div><div>– La prescription d’un traitement par méthylphénidate s’intègre dans une démarche globale, biopsychosociale.</div><div>– La prise en charge médicamenteuse du TDAH doit intégrer celle des comorbidités.</div></div><div><div>– Pharmacological management of ADHD is a second intention treatment that should be proposed after the failure of non-pharmacological treatments.</div><div>– First-line pharmacological treatments rely, in France, on methylphenidate-based medications.</div><div>– Another medication includes guanfacine that is also approved in France for children and adolescents with ADHD, but only as a last option treatment.</div><div>– The other medications available in France for persons with ADHD include either treatment prescribed in a compassionate use program (atomoxetine) or off-label treatments (i.e., clonidine).</div><div>– Prescribing methylphenidate should be included in a global and biopsychosocial perspective.</div><div>– Pharmacological management of ADHD should systematically include the assessment and treatment of its associated comorbid disorders.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 6","pages":"Pages 433-443"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656609","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 non médicamenteuse du TDAH","authors":"Lucia Romo ,&nbsp;Marie Thomas ,&nbsp;Thierry Hergueta ,&nbsp;Frédérique Amselem ,&nbsp;Maëva Roulin ,&nbsp;Alexandre Hubert","doi":"10.1016/j.lpmfor.2024.09.005","DOIUrl":"10.1016/j.lpmfor.2024.09.005","url":null,"abstract":"<div><div>– Le trouble déficit de l’attention avec ou sans hyperactivité (TDAH) se caractérise par des difficultés de régulation chez les enfants et les adultes atteints : régulation de l’attention, des émotions, du comportement et de la motivation.</div><div>– Avant d’envisager une prescription de méthylphénidate, les recommandations d’experts insistent sur la mise en place de thérapies non médicamenteuses pour améliorer la qualité de vie des sujets atteints et de celles de leurs proches.</div><div>– Cet article propose un aperçu des stratégies thérapeutiques qui existent chez l’enfant et chez l’adulte et qui pourront être proposées après évaluation des besoins spécifiques : la psychoéducation, les programmes d’entraînement aux habiletés parentales, les programmes de thérapies comportementales, cognitives et émotionnelles (TCCE) et les programmes de remédiation cognitive.</div></div><div><div>– Attention Deficit Disorder Hyperactivity (ADHD) is characterized by difficulties in regulating the attention, emotions, behavior and motivation of affected children and adults.</div><div>– Before considering prescribing methylphenidate, expert recommendations insist on the use of non-pharmacological treatment to improve the quality of life of sufferers and their families.</div><div>– This article provides an overview of the therapeutic strategies available for children and adults, which may be offered following an assessment of specific needs: psychoeducation, parenting skills training programs, behavioral, cognitive and emotional therapy (CBT) programs and cognitive remediation programs.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 6","pages":"Pages 427-432"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656610","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":"Relation entre microbiote gastrique et cancer de l’estomac","authors":"Cyrine Ben-Mehrez ,&nbsp;Dhouha Chérif ,&nbsp;Habiba Dabbebi ,&nbsp;Haythem Yacoub ,&nbsp;Hajer Hassine ,&nbsp;Héla Kchir ,&nbsp;Nadia Maamouri ,&nbsp;Kamel Ben-Mahrez","doi":"10.1016/j.lpmfor.2024.10.001","DOIUrl":"10.1016/j.lpmfor.2024.10.001","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Le microbiote hébergé par le tractus gastro-intestinal appelé microbiote intestinal ou flore intestinale, est le principal microbiote humain. Plus de 3 millions de gènes microbiens codant des milliers de métabolites ont été identifiés dans le microbiome intestinal humain. La composition du microbiote intestinal varie quantitativement et qualitativement en fonction des régions anatomiques de l’intestin. Malgré l’environnement acide de l’estomac, le microbiote gastrique est également complexe et diversifié. Le microbiote intestinal est acquis suite à la colonisation du tube digestif pendant les deux années qui suivent la naissance. La communauté microbienne typique qui s’établit chez l’adulte, se caractérise par une grande diversité, une relative stabilité, une capacité à la résilience aux perturbations et une interaction symbiotique avec l’hôte. Le déséquilibre des populations de la flore intestinale ou dysbiose est associé au développement de nombreuses pathologies digestives. La diversité élevée du microbiote gastrique dans l’estomac sain diminue chez les patients atteints de gastrite chronique atrophique, de métaplasie intestinale et de cancer gastrique, la progression du cancer étant corrélée à cette diminution de la diversité. Cette dysbiose, associée au cancer gastrique, se caractérise par un enrichissement en communautés microbiennes à potentiel nocif capables de générer des métabolites favorisant le développement de la tumeur, la modulation de l’inflammation, l’induction de dommages à l’ADN, la suppression de l’immunité anti-tumorale et l’activation des voies de signalisation oncogéniques. La thérapie par modulation du microbiote nécessite de définir l’équilibre de la flore intestinale avec précision et de bien identifier les communautés microbiennes liées au développement du cancer gastrique.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;The microbiota hosted by the gastrointestinal tract, called the gut microbiota or intestinal flora, is the primary human microbiota. Over 3 million microbial genes encoding thousands of metabolites have been identified in the human gut microbiome. The composition of the gut microbiota varies quantitatively and qualitatively according to the anatomical regions of the gut. Despite the acidic environment of the stomach, the gastric microbiota is also complex and diverse. The gut microbiota is acquired following the colonization of the gastrointestinal tract during the first two years after birth. The typical microbial community that establishes in adults is characterized by high diversity, relative stability, resilience to disturbances and symbiotic interaction with the host. The imbalance of the populations of the intestinal flora or dysbiosis is associated with the development of numerous digestive pathologies. The high diversity of the gastric microbiota in the healthy stomach decreases in patients with chronic atrophic gastritis, intestinal metaplasia and gastric cancer, with cancer progression correlated with this dec","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 6","pages":"Pages 385-390"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656650","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":"Ours redaction","authors":"","doi":"10.1016/S2666-4798(24)00178-2","DOIUrl":"10.1016/S2666-4798(24)00178-2","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 6","pages":"Page i"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656777","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":"TDAH et addictions : fardeau ou levier thérapeutique ?","authors":"Clémence Cabelguen ,&nbsp;Aude Begnaud ,&nbsp;Marie Grall-Bronnec","doi":"10.1016/j.lpmfor.2024.09.004","DOIUrl":"10.1016/j.lpmfor.2024.09.004","url":null,"abstract":"<div><div>– Plus de 20 % des patients suivis pour un trouble addictif seraient concernés par le TDAH.</div><div>– La présence d’un TDAH est associée à une expérimentation de substances psychoactives et à un trouble de l’usage de substances plus précoce et plus sévère, et à une péjoration du pronostic.</div><div>– Le TDAH est également fortement associé aux addictions comportementales (i.e., jeu d’argent pathologique, trouble du jeu vidéo, addiction au sexe) et aux troubles des conduites alimentaires (i.e., boulimie, hyperphagie boulimique).</div><div>– Comprendre le choix de l’objet addictif et la fonction de son usage est central dans la démarche diagnostique du TDAH.</div><div>– La démarche diagnostique en cas d’addiction comprend un examen de l’histoire développementale et d’éventuelles évolutions des symptômes attribuables à un TDAH selon l’évolution de l’addiction.</div><div>– Elle devrait débuter au plus tôt, en dehors des situations d’intoxication aiguë sévère et de sevrage, et autant que possible après une période d’arrêt de l’usage, si cela est accessible au patient.</div><div>– Le trouble le plus invalidant sera à traiter en priorité, dans une dynamique d’approche combinée et intégrative.</div><div>– Il s’agit de viser une certaine stabilité du trouble addictif avant d’instaurer un traitement pharmacologique du TDAH, tout en reconnaissant que le TDAH entretient les troubles addictifs et que sa prise en charge peut constituer un levier thérapeutique.</div></div><div><div>– More than 20% of patients seeking treatment for an addictive disorder meet the diagnostic criteria for ADHD.</div><div>– Comorbid ADHD is associated with an earlier age at first substances use and at onset of substance use disorder, a more severe substance use disorder, and a poorer prognosis.</div><div>– ADHD is also strongly associated with behavioral addictions (i.e., gambling disorder, gaming disorder, compulsive sexual behavior disorder) and eating disorders (i.e., bulimia, binge eating disorder).</div><div>– Understanding the motives underlying the use of a given addictive substance or behavior is a key point in the ADHD diagnosis process.</div><div>– In case of comorbid addictive disorder, diagnosis approach includes assessment of the developmental history and of the interaction between ADHD symptoms and the addictive disorder course.</div><div>– It should start early, apart from acute intoxication or withdrawal situations, and after a period of abstinence if possible.</div><div>– The most disabling disorder should be treated first, in a combined and integrated perspective.</div><div>– We should aim for stability of the addictive disorder before starting ADHD pharmacological treatment, but keep in mind that ADHD maintains the addictive disorder and that its treatment can also improve it.</div></div>","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 6","pages":"Pages 417-426"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656608","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":"TDAH de l’enfance à l’âge adulte : diagnostiquer, évaluer, comprendre et prendre en charge","authors":"Servane Barrault ,&nbsp;Jérôme Bachellier ,&nbsp;Nicolas Ballon ,&nbsp;Sarah El Archi ,&nbsp;Wissam El-Hage ,&nbsp;Paul Brunault","doi":"10.1016/j.lpmfor.2024.09.001","DOIUrl":"10.1016/j.lpmfor.2024.09.001","url":null,"abstract":"","PeriodicalId":100859,"journal":{"name":"La Presse Médicale Formation","volume":"5 6","pages":"Pages 392-396"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656649","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}