B Acad Nat Med Paris
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Despite the frequency of psychiatric comorbidities, substance use disorder must be understood as an autonomous pathology due to its own determinants, semiology and possibilities of evolution, either spontaneous or under treatment. The ease of access to multiple synthetic products via the Internet combined with the creativity of chemists are contributing to the emergence of novel practices ranging from chemsex to purple drank. ⋯ The physician needs to hear the patient powerlessness hidden behind the craving and propose a therapy that may be chemical (including substitution treatment) and psychological. Most of the time, social support is necessary to correct the desocializing effects of substance use disorder or addictive behaviours.
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B Acad Nat Med Paris · Jun 2020
Review[Abnormal consequences of non-faulty medical accidents: Jurisprudence of the Conseil d'État].
Compensation for no-fault medical accidents to professionals or establishments is provided for by article L. 1142-1 of the public health code, created by the law of March 4, 2002 relating to the rights of patients and the quality of the health system. It indicates the conditions of accountability, clinical criteria and severity. Among the clinical criteria "a medical accident (…) gives the right to compensation for damages (…) in the name of national solidarity, when (…) they have had abnormal consequences for the patient in view of his condition as well as the foreseeable evolution of it (…)". ⋯ According to the jurisprudence of the Conseil d'État of December 12, 2014 the condition of abnormality is always "satisfied when the medical act entailed consequences significantly more serious than those to which the patient was exposed in a sufficiently probable way in the absence of treatment". And if this is not the case, "they cannot be regarded as abnormal unless, under the conditions in which the act was performed, the occurrence of damage presented a low probability; that thus, they cannot be regarded as abnormal with regard to the state of the patient when the gravity of this state led to practicing an act involving high risks whose realization is at the origin of the damage". The Conseil d'État specified in 2019 that a probability of occurrence of 3% was a low probability.
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B Acad Nat Med Paris · Jun 2020
Editorial[Decorative tatoo complications: new informations justifiing pressing action].
Skin tattoos have been used for a long time but their toxicity remains little known to the general public who increasingly resort to these techniques without being informed of the risks involved, infectious, allergic, dermatological, systemic toxic and even ophthalmological. This situation is compounded by the fashion for "whole body" tattoos. This dedicated session is an update on the risks associated with tattoos.
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The most infectious diseases that veterinarians and doctors believed to have vanquished in the 1980s in developed countries, have repeatedly talked about them in an often dramatic way in the 2000s. Foot-and-mouth disease devastated British herds in 2001, bovine tuberculosis, which had been hoped for eradication after 50 years of fighting, has re-emerged in the United Kingdom and France... At the same time, new infectious diseases, often zoonotic, have appeared in animals and in humans : HP avian influenza H5N1 in 2003, SARS in 2003, the MERS-CoVin2012…The reasons for these emergences are multiple because each disease has its own determinants. ⋯ The constant movement of humans, animals and their products on the planet, densification of populations and massive displacements linked to conflicts are probably at the heart of these evolutions. For the future, the challenges are to understand the infectious risks linked to these evolutions in order to try to prevent them. Epidemiology through surveillance and investigation will be tomorrow more than ever, at the heart of the prevention of infectious diseases.