La Revue du praticien最新文献

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.

FRANCE'S FIRST "PESTICIDES AND PEDIATRIC PATHOLOGIES" CONSULTATION. The "Pesticides and Pediatric Pathologies" department of the Regional Center for Occupational and Environmental Diseases of Hauts-de-France (CHU Amiens-Picardie, France) was set up on October 1 2023, to support children (and their families) suffering from leukemia, brain tumors, hypospadias or cleft lip and palate whose parents have been professionally exposed to pesticides. This support includes assistance in dealing with the Fonds d'indemnisation des victimes de pesticides (Pesticide Victims Compensation Fund).

MECHANICAL CIRCULATORY SUPPORT AND REPLACEMENT IN HEART FAILURE. Technological developments have led to a panel of mechanical devices making possible circulatory support and cardiac replacement in patients with heart failure. Some devices (namely extracorporeal membrane oxygenation or ECMO) allow short-term support in patients with acute heart failure and improve the prognosis. Other devices (left ventricular assist device and total artificial heart) are designed for long-term use in patients with advanced heart failure; although heart transplantation remains the gold standard for these patients, mechanical support devices may keep patients alive until transplantation or become destination therapy if transplantation is contraindicated. The optimal use of mechanical circulatory support needs a strong organizational network of specialized multidisciplinary centers.

PREVENTING DENTAL ANXIETY IN ADULTS AND CHILDREN. In 2014, according to INSEE, dental anxiety affected 7% of the French population. Severity of anxiety can range from minor to severe, minor anxiety manifesting for patients as physical symptoms without compromising dental care to severe anxiety by avoiding dental consultation and compromising dental care. This article explains the problems associated with dental anxiety and suggests ways in which practitioners can help their patients to come to the dentist for dental care, in particular by using cognitive-behavioural therapies.