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Copyright of Néphrologie & Thérapeutique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Transition is a coordinated and progressive process aiming at the transfer of a young patient from a pediatric care to the adult health system. Transfer of medical care to adult facilities is a complex task requiring multiple involvements of both paediatric and adult care providers, taking into account the medical, psychosocial and educational needs of the youth. The Transition Working Group of the French Network for Rare Liver Diseases (Filfoie) proposes recommandations and tools in order to optimize the transition process and transfer of young people with chronic liver disease from child-centred to adult-centred healthcare services. [ABSTRACT FROM AUTHOR]

Transition is a coordinated and progressive process aiming at the transfer of a young patient from a pediatric care to the adult health system. Transfer of medical care to adult facilities is a complex task requiring multiple involvements of both paediatric and adult care providers, taking into account the medical, psychosocial and educational needs of the youth. The Transition Working Group of the French Network for Rare Liver Diseases (Filfoie) proposes recommandations and tools in order to optimize the transition process and transfer of young people with chronic liver disease from child-centred to adult-centred healthcare services. [ABSTRACT FROM AUTHOR]

Copyright of Environnement, Risques & Santé is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bulletin de la Societe de Pathologie Exotique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: La fibrillation atriale (FA) est fréquente chez le sujet âgé. Son traitement repose sur les anticoagulants pour prévenir un accident vasculaire cérébral (AVC) et les emboles systémiques. Les antagonistes de la vitamine K (AVK) ont longtemps été les seuls anticoagulants disponibles pour la prise en charge de la FA. Leur maniement complexe en a fait une des principales causes de iatrogénie chez le sujet âgé. Depuis près de 10 ans, les anticoagulants oraux d'action directe (AOD) ont fait leur apparition et de grands essais randomisés (RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE-AF) ont montré leur supériorité par rapport aux AVK dans la prise en charge de la FA. Ces essais ont été menés sur un très grand nombre de patients (n = 71 683), dont 27 500 ≥ 75 ans et près de 8 000 sujets > 80 ans. Les résultats de 11 méta-analyses récentes regroupant les données des essais randomisés et celles des études observationnelles de la « vraie vie » chez 660 896 personnes âgées indiquent que les AOD ont une meilleure efficacité que les AVK pour prévenir les accidents vasculaires cérébraux (AVC) (réduction du risque allant de 13 % à 26 %), et par rapport à ceux-ci présentent un moindre risque d'hémorragies cérébrales (réduction du risque de 50 %). Le risque d'hémorragie majeure apparaît lui, similaire ou moindre sous AOD que sous AVK (en fonction de la posologie, de la fonction rénale, du site hémorragique ou du type d'AOD). Par ailleurs, le bénéfice des AOD en comparaison aux AVK est retrouvé dans les analyses en sous-groupes chez les sujets de plus de 75 ans, chez les insuffisant rénaux (clairance créatine 30-50 mL/min) et chez les sujets chuteurs. Les analyses indiquent qu'en comparaison avec les AVK, les AOD apparaissent d'autant plus favorables que les patients sont âgés car ce sont eux qui présentent le plus haut risque d'AVC et d'hémorragies cérébrales. En résumé, les AOD présentent un profil efficacité/tolérance supérieur aux AVK, ce qui justifie leur utilisation en première intention chez le sujet âgé de plus de 75 ans. Atrial fibrillation (AF) is common in the elderly. The treatment of this condition is based on anticoagulation in preventing Stroke and systemic arterial embolism. Vitamin K antagonists (VKAs) have long been the only anticoagulants available for the management of AF. Difficulties handling VKAs have made them one of the main causes of iatrogenic disease in the elderly. In the last 10 years, direct-acting oral anticoagulants (DOACs) have emerged and large randomized trials (RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE-AF) have demonstrated their superiority over VKAs in the management of AF. These trials were conducted with large numbers of patients (n=71,683), including 27,500 aged ≥75 years and nearly 8,000 subjects aged >80 years. Results from 11 recent meta-analyses of randomized trials and observational real-world studies of 660,896 elderly patient indicate that DOACs are more effective than VKA-based prophylaxis in preventing stroke (risk reduction ranging from 13% to 26%) and carry a lower risk of cerebral hemorrhage (risk reduction 50%). The risk of major hemorrhage appears to be similar to or lower with DOACs than with VKAs (depending on the dosage, renal function, hemorrhagic site or type of DOACs). Moreover, a greater benefit of DOACs over VKA therapy has been found in subgroup analyses in subjects aged over 75 years, in patients with renal insufficiency (creatinine clearance 30-50 mL/min) and in those with a history of falls. Analyses indicate that DOACs are a better choice than VKAs in the elderly because elderly patients are those with the highest risk of stroke and cerebral hemorrhages. In summary, DOACs have a better efficacy/tolerance profile than VKAs, which justifies their first-line use in subjects over 75 years of age. [ABSTRACT FROM AUTHOR]

Copyright of Environnement, Risques & Santé is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gériatrie et Psychologie Neuropsychiatrie du Vieillissement is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Environnement, Risques & Santé is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as "the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care". Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors' selection of the most appropriate pharmacy practice journal to submit their work. [ABSTRACT FROM AUTHOR]

Copyright of Médecine is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Environnement, Risques & Santé is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Environnement, Risques & Santé is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Hépato-Gastro & Oncologie Digestive is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Médecine Périnatale is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Environnement, Risques & Santé is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Orthodontie Française is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Orthodontie Française is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Orthodontie Française is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal de Pharmacie Clinique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Les inégalités sociales de santé sont bien connues. En faire apparaître la dimension environnementale, c'est-à-dire la façon différenciée et inégale dont l'environnement affecte les individus et les populations, particulièrement en ce qui concerne la santé, c'est faire apparaître une autre dimension du social. Cela oblige à déplacer l'attention du seul emploi vers le milieu de vie. C'est donc comprendre que l'environnement comme la santé ne se résument pas à un ensemble de données objectives ; ils ne concernent pas que le monde et le corps connus mais également le monde et le corps vécus. Après avoir dressé, dans une première partie, un tableau général des inégalités environnementales, nous les étudierons plus précisément, dans une deuxième partie, dans leur rapport à la santé. Nous en examinerons alors, dans une troisième partie, les différentes approches quantitatives et leurs limites. Much is known about health inequalities in society. Here, we focus on their environmental dimension, that is, the diverse and unequal ways in which the environment impacts individuals and populations, their health in particular. This enquiry changes our conception of social issues, by shifting attention from the job issue alone to the more complex one of the living environment. We explain that neither the environment nor health can be seen merely in terms of objective data. It is not so much a question of how well we know our world and our bodies, but how we experience them. In the first part of this paper we provide an overview of the general issue of environmental inequalities before addressing their relation to health. Lastly, we examine the quantitative approaches and their limitations. [ABSTRACT FROM AUTHOR]

Copyright of Hépato-Gastro & Oncologie Digestive is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Avec la pandémie de SARS-CoV-2, dans notre établissement, les lits de salle de surveillance post-interventionnelle du bloc opératoire ont été transformés en lits de réanimation non-COVID. Le service de pharmacie a accompagné les équipes au cours des trois périodes, avec la mise en place d'un circuit du médicament adapté : création d'une armoire de dotation, fréquence d'approvisionnement, dispensation nominative et présence pharmaceutique. Objectifs : évaluer l'organisation pharmaceutique mise en place, la satisfaction des équipes infirmiers et recueillir des axes d'amélioration. Méthode : un questionnaire a été remis aux infirmiers ayant travaillé dans cette unité. Résultats : au total, 155 patients, soit une analyse de 111 prescriptions, ont été pris en charge sur 126 jours d'ouverture de cette unité. L'ensemble des infirmiers ayant participé aux trois périodes ainsi que le cadre de santé ont complété le questionnaire, soit 21 réponses. L'étape ressentie comme la plus difficile est la prescription (48 %) liée au support papier utilisé. La présence pharmaceutique a été appréciée à 90 %, notamment pour des demandes d'approvisionnement d'un médicament (95 %), ou d'information sur un médicament (58 %). Il est souhaité (90 %) que cette présence soit renouvelée en cas de réouverture de l'unité. Une amélioration de la satisfaction est constatée à chaque période. Conclusion : en cas de nouvelle vague, il a été décidé de poursuivre le détachement d'un pharmacien pour sécuriser le fonctionnement de ce type d'unité, notamment par l'analyse quotidienne des prescriptions avec les médecins et par l'interaction avec les infirmiers pour le bon usage du médicament. During the SARS CoV-2 pandemia and at three separate time period, our institution chose to turn the post interventional surveillance room of the operating room into a non-COVID intensive care unit. The chosen workflow included that the pharmacy team provided support to the medical team and was instrumental to implement an adapted drug circuit, including the creation of a supply cabinet, a specific frequency of its supply, a nominative dispensation and the presence of a pharmacist. Objectives : The study aims to evaluate the proposed pharmaceutical organization workflow, the satisfaction of the nursing team and to collect their expert feedback for improvement. Method : A satisfaction survey questionnaire was set up and given to the nurses who worked in this temporary unit. Results : A total of 155 patients, i.e. an analysis of 111 prescriptions, were treated during the 126 days during which the unit was running. All the nurses who participated to the three time periods and the health care manager completed the questionnaire, i.e. 21 responses. The step that was felt to be the most difficult was prescribing (48%) due to the paper medium used. The presence of a pharmacist in the medical unit was appreciated by 90% of the survey respondents, particularly for requests on the supply of a drug (95%), or on drug information (58%). 90% of the respondents were hoping that this experience would be renewed if the unit opens again. An increase of the satisfaction due to the pharmaceutical presence is reported in each successive period. Conclusion : In case of an eventual new epidemic wave, it was decided to continue to assign a pharmacist to the non-COVID intensive care unit, in order to protect the unit performance. The survey revealed that two key factor are instrumental to this success, a daily analysis of prescriptions with the physicians and the on-site interaction with the nurses for the promotion of the right use of medications. [ABSTRACT FROM AUTHOR]

Résumé: Après un premier article portant sur l'aspect théorique [1], place à la partie opérationnelle de la gestion de projet illustrée par deux solutions organisationnelles (SO) publiées en 2019 par l'Agence nationale d'appui à la performance des établissements de santé et médico-sociaux (ANAP). Du cadrage de projet jusqu'à sa clôture en passant par la mise en œuvre, cet article propose une méthodologie illustrée par un cas concret que les pharmaciens hospitaliers pourront appliquer pour mener leurs projets. Elle s'accompagne de nombreux outils tels qu'un tableau de Kanban, un plan de communication, une note de cadrage. Ces éléments primordiaux dans la pratique quotidienne du pharmacien hospitalier, pourraient à moyen terme être connus et acquis dès notre formation initiale pour répondre aux nouveaux enjeux du métier de pharmacien hospitalier. Following our first paper on theoretical issues of project management [1], we address in this one the practical part, illustrated by two organizational solutions (OS) published in 2019 by the Agence Nationale d'Appui à la Performance des établissements de santé et médico-sociaux (ANAP). From the definition of the project to its implementation and completion, this article provides a methodology illustrated by a concrete case that hospital pharmacists could apply to their own projects. It also provides many tools such as a Kanban board, a communication plan and a scoping note. These elements are already essential in the daily practice of the hospital pharmacist and we suggest that this should be acquired during our initial training to meet the new challenges of the hospital pharmacist's profession. [ABSTRACT FROM AUTHOR]

Résumé: Les maladies des petits artères cérébrales (MPAC) sont une cause fréquente d'accidents vasculaires cérébraux (AVC), qu'ils soient ischémiques ou hémorragiques. Une petite proportion des MPAC résulte de pathologies monogéniques. Bien qu'elles soient rares, l'identification de ces formes monogéniques est cruciale, permettant d'offrir une prise en charge adaptée à ces patients et à leurs apparentés. Dans cette revue, les principales situations devant conduire le clinicien à évoquer une forme monogénique de MPAC sont listées, et les principales caractéristiques des différentes MPAC connues à ce jour sont résumées. Cerebral small vessel diseases (cSVD) represent a common cause of stroke, either ischemic or hemorrhagic. Only a small proportion of cSVD results from monogenic conditions. Although they are involved in a minority of patient, the accurate identification by physicians of hereditary forms of cSVD is crucial for the medical care of these patients and their relatives. In this paper, the main situations that must lead physicians to suspect a hereditary cSVD are listed, and the key characteristics of the monogenic cSVD known to date are summarized. [ABSTRACT FROM AUTHOR]

Résumé: L'immunothérapie anticancéreuse est en plein essor grâce au développement des inhibiteurs du checkpoint immunitaire. Ces anticorps monoclonaux ciblant notamment le CTLA-4 et le PD-1 permettent de stimuler l'immunité antitumorale de l'hôte. Ils ont d'abord transformé le pronostic du mélanome métastatique et de certains cancers broncho-pulmonaires à petites cellules. Ces bénéfices s'étendent progressivement à de nombreux autres organes et notamment aux cancers du tractus gastro-intestinal. Bien que leur efficacité réside dans leur effet immunologique, la contribution du microbiote intestinal est désormais indéniable, jouant un rôle sur l'efficacité et la tolérance des inhibiteurs du checkpoint immunitaire. En effet, certains patients peuvent développer des effets indésirables immuno-médiés et notamment des entérocolites qui miment une maladie inflammatoire chronique de l'intestin. Cet article décrit plus particulièrement les liens entre microbiote intestinal et inhibiteurs du checkpoint immunitaire. Cancer immunotherapy use and more specifically checkpoint inhibitor is currently rising based on dramatic improvement of prognosis of many cancers such as metastatic melanoma and some subtypes of lung cancer. Checkpoint inhibitors are now implemented in many other cancers including those of the gastrointestinal tract. The contribution of intestinal microbiome has been suggested through many studies allowing some microbial fingerprints to predict efficacy and safety. Indeed, some patients may experience immune-related adverse events notably enterocolitis mimicking inflammatory bowel disease. This paper describes the specific contribution of intestinal microbiome to efficacy and safety of checkpoint inhibitors. [ABSTRACT FROM AUTHOR]

Copyright of Orthodontie Française is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal de Pharmacie Clinique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Phytothérapie is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Une approche participative a été promue par Santé publique France pour étudier la santé des populations exposées à l'incendie des usines Lubrizol et NL Logistique en septembre 2019. Elle vise à partir des questions que se posent les parties prenantes et à les associer à la construction de l'enquête et à l'analyse des résultats. Dans cet article, la personne en charge de la coordination de cette approche présente les critères à partir desquels le rôle des parties prenantes s'est élaboré, ainsi que sa façon d'appréhender la participation. The French Public Health Agency promoted a participatory approach to study the health of populations exposed to the fire in the Lubrizol and NL Logistique plants in September 2019. Based on the preoccupations of stakeholders, it involves them in the construction of the survey and the analysis of the results. In this paper, the coordinator of this approach presents the criteria used to define the role of the stakeholders and his approach to participation as a process. [ABSTRACT FROM AUTHOR]

Résumé: En septembre 2019, un incendie a démarré dans le stockage de l'usine Lubrizol, spécialisée dans la fabrication d'additifs pour lubrifiant et située près de la ville de Rouen. Cet incendie a déclenché une crise importante en raison d'un panache visible de 22 km de long, qui a survolé la ville et induit des restrictions temporaires à plus de 100 km du sinistre. L'objectif de ce travail est de proposer une approche pragmatique de la gestion des incendies mettant en jeu de nombreux produits stockés à différents endroits, à différentes phases de leur cycle de vie, depuis le site du producteur jusqu'à l'utilisateur final en passant par les grands entrepôts de stockage. L'analyse proposée porte sur la gestion de crise, sur les demandes associées au développement d'un tel sinistre et aux données techniques disponibles pour y répondre. Elle expose les leçons tirées de l'incendie de l'usine Lubrizol pour l'amélioration de la gestion opérationnelle d'un tel sinistre, certes rare mais susceptible d'avoir des conséquences graves sur la santé et l'environnement à court, moyen et long termes. The Lubrizol/NL Logistique fire took place in the storage facility of the Lubrizol plant specialized in manufacturing lubricant additives close to the city of Rouen in September 2019. It triggered a significant crisis due to the 22 km-long visible fire plume that drifted over the town and induced temporary consequences over 100 km from the fire source. This paper focuses on a holistic analysis of major fire scenarios involving numerous products stored throughout their industrial life in warehouses or other storage premises, from manufacturer to end user. It covers the emergency crisis management and related demands and includes the available technical data. It also shows the lessons to be drawn from the Lubrizol case to improve operational anticipation of these rare but potentially highly impactful events, in terms of health, environmental, and sanitary issues, both in the short term from emission release to complete extinction and later, induced by post-exposure effects and all types of transfers to the environment. [ABSTRACT FROM AUTHOR]

Résumé: Après 12 mois de circulation virale, le SARS-CoV-2 a infecté des millions de personnes dans le monde, faisant des centaines de milliers de morts. En l'absence de traitement curatif, préventif ou vaccinal efficace et accessible à ce jour contre le Covid-19, recourir à des médicaments déjà existants pourrait aider à enrayer la pandémie. La vitamine D est un candidat possible discuté dans de nombreuses publications. Des essais cliniques randomisés montrent que la supplémentation en vitamine D réduit significativement le risque d'infections respiratoires. Il existe également de nombreux arguments suggérant que l'hypovitaminose D constitue un facteur de risque indépendant (et facilement modifiable) des formes graves de Covid-19 et de mortalité par Covid-19. La supplémentation en vitamine D est une mesure simple, sans risque, peu coûteuse et remboursée par l'assurance maladie, qui est efficace pour corriger l'hypovitaminose D retrouvée chez 40 à 50 % de la population française et chez plus de 80 % des adultes atteints de Covid-19. Dans ce papier de position, nous proposons des schémas simples de supplémentation vitaminique D chez l'adulte en l'absence ou en cas de Covid-19. After 12 months of viral circulation, the SARS-CoV-2 has infected millions of people around the world, leaving hundreds of thousands dead. With the lack of effective therapy and vaccination against COVID-19, focusing on the immediate repurposing of existing drugs gives hope of curbing the pandemic. Vitamin D is a possible candidate discussed in a high amount of publications. Randomized clinical trials show that vitamin D supplementation significantly reduces the risk of respiratory infections. There are also many evidences that hypovitaminosis D is an independent (and easily modifiable) risk factor for severe forms of COVID-19 and death. Vitamin D supplementation is a simple, safe and inexpensive measure, which is effective in correcting hypovitaminosis D found in 40-50% of the French population and in more than 80% of adults with COVID-19. In this position paper, we propose simple regimens (adapted to the pharmaceutical forms currently available in France) for vitamin D supplementation in adults with or without COVID-19. [ABSTRACT FROM AUTHOR]

Résumé: Les sténoses œsophagiennes bénignes sont fréquentes en pathologie digestive et sont à l'origine d'une dysphagie avec altération de la qualité de vie. Le traitement par dilatation endoscopique est la référence, avec souvent plusieurs sessions nécessaires de dilatation pour lever l'obstacle (trois à cinq). Les sténoses œsophagiennes réfractaires sont celles qui récidivent après cinq dilatations. La prise en charge de ces sténoses réfractaires est basée sur l'optimisation du traitement par inhibiteurs de la pompe à protons (IPP), les dilatations itératives, et des thérapies endoscopiques adjuvantes comme l'injection de corticoïdes dans la sténose pour les sténoses inflammatoires, les incisions radiaires dans les sténoses courtes ou encore la pose d'une prothèse œsophagienne couverte pendant quatre à six semaines, dont l'effet est souvent transitoire. Malgré de nombreuses études, la prise en charge des sténoses œsophagiennes réfractaires reste un problème important de prise en charge pour les praticiens et les patients. Nous faisons ici le point sur les données disponibles de la littérature pour la prise en charge des sténoses œsophagiennes réfractaires bénignes. Benign esophageal strictures are common in digestive diseases and led to dysphagia with an impaired quality of life. Treatment by endoscopic dilation is the reference, often with several sessions of dilation to remove the obstruction (three to five sessions). Refractory strictures are those that recur after five dilations. The management of these refractory strictures is based on the optimization of PPI treatment, iterative dilations, and adjunctive endoscopic therapies such as corticosteroid injections into the stricture for inflammatory strictures, radial incisions in short strictures, or covered esophageal prosthesis placement for four to six weeks. Despite numerous studies, the management of refractory stricture remains an important issue for physicians and patients. This paper reviews the literature available today for the management of benign refractory strictures in the esophagus. [ABSTRACT FROM AUTHOR]

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Copyright of Médecine Thérapeutique: Pédiatrie is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Les promesses de scientifiques ont fait émerger le grand projet NBIC (Nano, Bio, Info et Cognition) qui avait pour but d'augmenter les performances humaines, en même temps qu'on allait, grâce à la taille des nanomatériaux et la puissance des nanotechnologies, trouver de nouvelles applications industrielles et médicales. Le débat irréductible entre une technologie qui peut tout et des idéologies farouchement opposées s'est traduit par une crise d'intellectuels sur des choix de société, crise plutôt invisible pour le public général. Depuis quelques dizaines d'années, notre monde est traversé par de « vraies » crises sanitaires, crises qui sont comparées avec ce qui aurait pu émerger depuis le débat public « nano » de 2009. Non seulement le public ne manifeste plus d'inquiétudes majeures vis-à-vis des nanotechnologies, mais une enquête réalisée pour cet article confirme cette situation avec une certaine attractivité pour la nanomédecine. Cependant, si le domaine rentre aujourd'hui dans une forme de conformité presque « rassurante », son développement n'est pas aussi « spectaculaire » que prévu. Il n'en est pas moins nécessaire qu'en absence de l'usage du principe de précaution pour des dangers et des expositions non connus, une attention soit maintenue, associée à des recherches de toxicologie, pour éviter des effets inacceptables. Continuing scientific progress has led to the emergence of the great NBIC (Nano, Bio, Info and Cognition) project, aimed at increasing human performance and simultaneously, thanks to the size of nanomaterials and the power of nanotechnology, finding new industrial and medical applications. The relentless debate between a technology that can do everything and ideologies fiercely opposed to that goal has resulted in a battle between intellectuals over societal choices that is almost invisible to the general public. For several decades now, our world has been going through "real" health crises that are compared with what could have emerged since the public debate of 2009 about "Nano". The public is no longer concerned about nanotechnology, and a survey conducted for this paper even reveals the attraction of nanomedicine. However, while the field is now entering a certain almost reassuring conformity, its development is not as spectacular as expected. If the precautionary principle for unknown dangers and exposures continues to be ignored, careful attention should be maintained, along with toxicological research, to prevent unacceptable effects. [ABSTRACT FROM AUTHOR]

Résumé: La programmation de la recherche est devenue une habitude récurrente de la part des pouvoirs, comme si on pouvait réellement imaginer et être créatifs sous contraintes. Cependant, la restriction de la liberté a un prix, celui d'une évaluation au fond (pas uniquement avec des indicateurs quantitatifs). Cette mise en défaut des systèmes trop programmatifs se traduit trop par des améliorations incrémentales qui satisfont les décideurs en ce que leur prise de risque et leur responsabilité sont modestes. Mais pour autant, dans le décor sombre d'un futur perturbé par des effets environnementaux majeurs, ces petits pas risquent juste de faire reculer une date de fin possible de l'humanité (collapsologie). Laisser de l'espace à des créatifs pour faire émerger des innovations de rupture est peut-être un moyen de changer la donne. Si l'on n'est pas sûr de gagner, c'est une voie nouvelle à tester et à soutenir pour autant que nombre d'inerties soient éliminées du jeu intellectuel de la recherche à risque. C'est cette volonté d'ouvrir le débat qui fait l'objet du présent document. Research programming has become a recurring habit on the part of the powers that be, as if one can really be creative and imaginative under constraints. But the restriction of freedom comes at a price, that of an evaluation in substance (not only with quantitative indicators). This failure of overly programmatic systems too often results in incremental improvements that satisfy decision-makers in that their risk-taking and accountability are modest. But for all that, against the bleak backdrop of a future disrupted by major environmental effects, these small steps risk merely postponing back a possible end date for humanity. Empowering creative people to invent breakthrough innovations is perhaps one way to change the present situation. While we are not sure of winning, it is a new pathway to be tested and supported, provided that inertia is eliminated from the intellectual game of risky research. This willingness to open the debate is the subject of this paper. [ABSTRACT FROM AUTHOR]

Résumé: Cet article retrace la prise en charge scientifique, politique et réglementaire des perturbateurs endocriniens entre 1990 et 2019 afin d'expliquer comment ces substances sont passées d'un objet scientifique à une catégorie réglementaire. L'histoire scientifique des perturbateurs endocriniens, l'estimation des coûts qu'ils engendrent et leur responsabilité dans les pathologies humaines modernes font déjà l'objet de nombreux travaux. Nous proposons une approche originale issue d'une étude en sciences sociales s'appuyant sur des entretiens, l'étude d'archives et de documents scientifiques, administratifs et associatifs, en vue de comprendre pourquoi, encore aujourd'hui, la question de la définition et de l'identification des perturbateurs endocriniens fait débat. Ce travail montre que dans les années 1990 l'invention et la diffusion de l'expression « perturbateurs endocriniens » suscitèrent le rassemblement de scientifiques de disciplines différentes (biologistes, écotoxicologues, chimistes, épidémiologistes, endocrinologistes, etc.) en vue de créer une communauté de recherche. C'est au gré des transferts dans les espaces administratifs, politiques et médiatiques que les perturbateurs endocriniens sont devenus une catégorie réglementaire. À partir de leur inscription dans le droit européen en 2009 dans le Règlement (CE) N̊ 1107/2009 concernant la mise sur le marché des produits phytopharmaceutiques, les experts scientifiques, fonctionnaires européens et parties prenantes ont dû élaborer de nouvelles manières de caractériser cette catégorie de substances chimiques. Ne pouvant pas reproduire les modes de gestion classiques reposant sur l'identification d'un effet néfaste comme dans le cadre du règlement relatif à la classification, à l'étiquetage et à l'emballage des substances et des mélanges (par exemple, pour les substances cancérigènes), une identification en trois étapes a été proposée, fondée sur l'identification d'un effet néfaste d'un mode d'action endocrinien et l'établissement d'un lien causal entre le mécanisme et l'effet. This paper retraces the scientific, political, and regulatory history of endocrine disruptors from 1990 through 2019 and explains how they became a regulatory category. Much work has already examined their scientific history, estimates of the costs they generate, and their responsibility for modern human disorders. We propose an original approach derived from the sociology of science, based on interviews and the study of archival and more recent scientific, administrative, and organizational documents to understand why the definition and identification of endocrine disruptors remain a topic of debate even today. This work demonstrates that in the 1990s the invention and diffusion of the term "endocrine disruptors" inspired interaction between scientists from different disciplines (biologists, ecotoxicologists, epidemiologists, and endocrinologists) to create a transdisciplinary research community. Its transfer to the administrative, political, and media areas made these endocrine disruptors into a regulatory category. They entered European law in 2009 with Regulation (EC) No. 1107/2009 concerning the placing of plant protection products on the market. At that point, scientific experts, European officials, and stakeholders had to develop new ways to characterize this category of chemical substances. The conventional management methods based on the identification of an adverse effect, as in the Regulation on the classification, labelling and packaging of substances and mixtures (for carcinogenic substances, for example), cannot be applied to these chemicals. Accordingly, a three-step identification process has been proposed that requires the identification first of an adverse effect and then of its endocrine mode of action, and finally the establishment of a causal link between the mechanism and the effect. [ABSTRACT FROM AUTHOR]

Résumé: Après avoir esquissé les grandes lignes de la biographie de AR Luria, cet article présente ses travaux en psychologie générale, essentiels pour la compréhension de sa conception de la neuropsychologie : 1) sa participation à la construction de la théorie historique et sociale de la psychologie, développée avec LS Vygotski ; 2) le rôle du langage dans le développement des activités psychiques supérieures chez l'enfant (i.e. conscientes et volontaires) et, tout particulièrement, la régulation du comportement par le langage intérieur. Starting with an overview of AR Luria's biography, we will present his works in general psychology which are key to his conception of neuropsychology (this will be developed in a forthcoming paper). We will focus on the construction of the historical and cultural theory of psychology developed with LS Vygotski, according to which, in man, the natural mental activities, related to the genetic evolution and shared by all humankind, are transformed into higher cortical functions (that is conscious and voluntary activities) through the mediation of language and the products of social activity, thus differ according to the development of societies. We review the Luria's studies devoted to support the theory in his expeditions in Central Asia, his studies in twins and intellectual disabled children, and the demonstration of the role of speech in the child development of the higher mental activities and regulation of behavior. [ABSTRACT FROM AUTHOR]

Copyright of Environnement, Risques & Santé is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Environnement, Risques & Santé is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Cet article revient sur l'évolution des collaborations entre associations et instituts d'expertise dans le domaine de la santé environnementale en France de 1990 à aujourd'hui. L'article décrit la manière dont les organismes d'expertise se sont adaptés à un nouveau contexte, plaçant leurs collaborations avec les associations au cœur des agendas institutionnels. En retraçant la généalogie des politiques d'ouverture à la société, nous donnons à voir les enjeux, les différents groupes d'acteurs embarqués, ainsi que les normes et les procédures à travers lesquels ces politiques sont mises en œuvre. Enfin, nous soulignons les principales limites de ces politiques, dessinant des perspectives aux associations et organismes d'expertise pour poursuivre le changement enclenché. This paper reviews the evolution of alliances between advocacy groups and associations, on the one hand, and scientific institutes and agencies, on the other, in the field of environmental health in France from 1990 until now. The article describes how these public institutions of expertise have adapted to a new context, placing their collaborations with associations at the heart of their institutional agendas. By retracing the history of opening policies to society, we show the stakes, the different groups of actors involved, as well as the norms and procedures by which science reaches out to society. Finally, we highlight the main limitations of these policies and outline opportunities for associations and expertise organizations to continue this change. [ABSTRACT FROM AUTHOR]

Copyright of Douleur et Analgésie is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Le dernier congrès de l'ISPOR Europe (International society for pharmacoeconomics and outcomes research) s'est tenu à Copenhague du 2 au 6 novembre 2019. Un groupe de pharmaciens, médecins et économistes en santé en synergie avec un groupe d'étudiants en master 2 de médico-économie présents à Copenhague, ont choisi de vous en restituer les messages forts. Cette synergie de groupe vise à développer « l'approche de la médico-économie sous toutes ses facettes ». Dans cet article, les auteurs évoquent les questions issues des différentes sessions et/ou posters, notamment l'évaluation des produits de santé : comment accélérer l'accès au marché des traitements tout en garantissant la pertinence clinique et la maîtrise des dépenses ? The last congress of ISPOR Europe (International society for pharmacoeconomics and outcomes research) was held in Copenhagen from 2 to 6 November 2019. A group of pharmacists, physicians and health economists in synergy with a group of students in Master 2 of medico-economics attending the conference have chosen to share some of the highlights. This group synergy aims to develop "the medico-economic approach in all its facets". In this paper, the authors discussed the following questions from the different sessions and/or posters, in particular the evaluation of health products: how to accelerate access to the treatment market while ensuring clinical relevance and control of spending? [ABSTRACT FROM AUTHOR]