La Revue du praticien最新文献

RECENT EVOLUTION OF THE EPIDEMIOLOGY AND BURDEN OF INVASIVE MENINGOCOCAL DISEASE. The landscape of invasive meningococcal disease (IMD) has changed considerably since the COVID-19 pandemic. The number of cases has decreased significantly following the non-pharmaceutical interventions employed to counter the pandemic, but vaccination rates were also lower during the pandemic than pre-pandemic levels. Once the health restrictions were lifted, IMD rapidly rebounded, initially with a resurgence in adolescents/young adults, then in other age groups, reaching a higher number of cases in 2023 than in the pre-pandemic period, with profound epidemiological and genotypic changes, particularly for serogroups W and Y. The number of serogroup C cases remains very low, thanks to the protection offered by the serogroup C conjugate vaccination program for children.

ACCIDENTS AT WORK, OCCUPATIONAL DISEASES AND WORK-RELATED. DISEASES: TO SEE MORE CLEARLY. Occupational factors have a major impact on population health. Occupational diseases or work-related diseases and accident at work are diverse and multifactorial. Nevertheless, exposure to occupational risk factors and associated disorders are avoidable. Preventive actions must be applied and adapted to working conditions and working population characteristics. Recognition of the professional origins allows for treatment and various financial compensation. Medical professions have a major role in supporting patients by considering the possibility of a professional origin.

AFTER-EFFECTS OF INVASIVE MENINGOCOCCAL DISEASES. Invasive meningococcal infections (IMI) still have a mortality rate of 11% in France. Recent nationwide studies have been able to quantify the long-term sequelae among survivors and highlight their diversity. In addition to the immediate effects seen at the end of hospitalization, numerous sequelae can emerge months or even years later. It is currently estimated that 20 to 30 % of survivors will experience at least one sequela, with 9 to 10 % having multiple after-effects. The most common sequelae are neurological (such as epilepsy and severe motor disorders) and psychological (like anxiety). Physical after-effects, such as skin scarring or amputations, while less frequent, often entail significant treatment cost. Cognitive difficulties, academic-learning challenges, and psychological, behavioral, or emotional disorders, are frequently diagnosed late and are probably underestimated. Communication or language problems carry a risk ratio > 20 compared to controls. This wide range of sequelae contributes to the complexity and high cost of care. It shows the importance of obtaining the most accurate possible estimate of IMI's impact and their after-effects, as well as implementing the preventive measures now available.

Women's particular pulmonary susceptibility to tobacco: THE EXAMPLE OF COPD . Women are more susceptible to the harmful effects of smoking than men, even with moderate exposure, and this vulnerability begins in childhood. The prevalence of smoking has even increased, in certain age groups of women, in France between 2019 and 2021. The consequences of smoking are chronic obstructive pulmonary disease (COPD), which develops earlier and more severely in women, even with mild exposure to tobacco, frequently leading to comorbidities such as osteoporosis and anxiety-depressive disorders. Several factors, mechanical, genetic, hormonal, and inflammatory, explain the vulnerability of the female lung to smoking. The management of smoking in women requires a gender-specific approach, including early detection of COPD and appropriate smoking cessation methods.