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Able to work in any sector, with patients of any age and from any socioeconomic or cultural background, the state-qualified nurse is a front-line player, likely to come into contact with victims of violence between (ex) intimate partners. In the current context of growing awareness of the concept of coercive control, this caregiver has a vital role to play in preventing this health and social scourge., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Competing Interests: Les auteurs déclarent n’avoir aucun lien d’intérêts.

Care organization in oncology. The health care organization for cancer patients has been built with the passing and current cancer plans, and the coordination of all the actions against cancer by the French national cancer institute. The authors describe the several phases of a patient pathway during and after cancer treatment, underline the importance of supporting good practice guidelines for health professionals, certification criteria and cancer authorization decrees for health care institutions, as well as coordination structures, and describe the specific organizations for children and elderly patients with cancer and for patients with rare cancers. Constant adaptation of the health care organization for cancer is necessary because of the rapid evolution of the treatments, as the development of ambulatory surgery and of oral chemotherapy in outpatients., Competing Interests: Les auteurs déclarent n’avoir aucun lien d’intérêts.

Unlabelled: Measuring waiting times is a good indicator of quality of cancer care and could reveal inequalities in cancer care access., Aims: To determine the most representative waiting times in breast, lung, colon and prostate cancer care in several regions of France. To analyze the influence of individual, medical or health care system factors on those waiting times., Methods: This study was piloted by the French Cancer Institute in partnership with the National Federation of the Regional Health Observatories and was driven by the Regional Oncology Networks and the Regional Health Observatories. In 2011, 2,530 women with breast cancer and 1,945 patient with lung cancer were included in eight regions, and in 2012, 3,248 patients with colon cancer and 4,207 men with prostate cancer were included in 13 regions, two of which were overseas departments. Data were analyzed from multidisciplinary discussion reports and from medical records., Results: The mean time intervals (± standard deviation) for the various components of access to care were as follows in breast cancer: mammography to pathologist diagnosis, 17,7 days (±15,9); diagnosis (or treatment proposal) to surgery, 22,9 days (±13,9). In lung cancer: first suspect medical image to pathologist diagnosis, 21,5 days (±17,6); diagnosis to treatment proposal, 13,5 days (±10,7). In colon cancer: coloscopy to pathologist diagnosis, 4,5 days (±4,1); diagnosis to surgery, 18,9 days (±14,9). In prostate cancer: pathologist diagnosis to treatment proposal, 36,5 days (±26,5); treatment proposal to surgery, 45,2 days (±30,1). Data collection was particularly difficult because of very heterogeneous way in medical records filling by care centers, so the data collection method used in the study could not be used in routine procedures. Waiting times measured in the four cancers had an important variability. In fact, age, circumstance of diagnosis, tumor stage and category of care center had an influence. After considering those different factors, differences between regions remained from range 2 to 4. Those regional differences could be explained by organizational factors but were not explored in our study. In the same way, data on individual factors (social vulnerability, category of employment) were not available to measure their effects on this study. Besides, our results were comparable to those in international publications or national recommendations in other countries., Conclusion: These results suggest that waiting times could be good indicators and could reveal inequalities in cancer care access. Measuring them would lead to characterize those inequalities and to propose actions to improve access to cancer care whose impact could be measured.

Perforation of the colon during colonoscopy is still one of the most severe complications of this technique and occurs with a frequency of between 0.12 % and 0.2 % of cases after diagnostic colonoscopy and in up to 3 % of patients after therapeutic colonoscopy. The site of perforation is usually the sigmoid colon. The gold standard for treatment of this complication is surgery to be performed as rapidly as possible: a simple suture and peritoneal cleaning, with limited resection and anastomosis or colostomy only in case of confirmed fecal peritonitis. However, interventional endoscopy has made progress, in particular endoscopic suturing and Natural Orifice Transluminal Endocopic Surgery (NOTES) has been developed. There are several reports of endoscopically sutured perforated colons, most less than 10mm. We report our experience of two colonic perforations which were at least 10mm treated by endoscopic suturing with hemoclips: a perforated sigmoid diverticulum during simple colonoscopy in the first case and a large polypectomy by endoscopic mucosal resection of the ascending colon in the second., (Copyright (c) 2009 Elsevier Masson SAS. All rights reserved.)

The 2009 news in medicine regarding dependence confirm the bio-psycho-social field of addiction medicine and psychiatry. First a statement is made about the risk of cardiac arythmy in opioid substitution treatments. Then a review of the treatment of C hepatitis shows its importance in an addicted population. In the field of cognitive neuroscience, progress has been made in the knowledge of "craving" and of its endophenotypical components. Electronic medias related disorders are on the border of addiction: a case study is exploring this new domain. At last, recent datas are presented on the relationship between cannabis and psychosis.

A case of giant bronchocele is reported. This lesion is due to a mucus and pus filled dilatation of the bronchial tree proximal to a stenosis. The latter can be either congenital or acquired, or in the context of a diffuse bronchopathy, which can be responsible for a functional stenosis. Both plain radiography and computed tomography findings are diagnostic. The etiology of the abnormality however represents an important problem to be solved. Further, a thoractomy is often necessary, except in those case arising in the context of a diffuse bronchopathy, which usually resolve either spontaneously or following medical treatment.

Eleven patients underwent choledochoduodenostomy under laparoscopic control: 5 for adenocarcinoma of head of pancreas, including 2 with extension into duodenum, 3 for chronic pancreatitis. 1 for gastric carcinoma with pancreatic infiltration 1 for carcinoma of ampulla and 1 for stenosing papillitis. Mean duration of operation was 97.9 minutes and mean hospital stay 7.8 days. No immediate or delayed postoperative complications were reported. The advantages of this method are the marked reduction in recovery time, especially in severely debilitated elderly patients, and the absence of postoperative pain.

A new technique for administering oxygen to patients with severe chronic respiratory failure is reported. It consists of introducing a catheter, 2 mm in diameter, into the trachea between the second and third tracheal rings under local anesthesia. The technique was used in a 70-year old patient with severe chronic obstructive lung disease and resulted in significant reduction of dyspnoea, improvement in general condition with a weight gain of 6 kg in 6 months, and a 15 mmHg increase in arterial partial oxygen pressure for the same oxygen flow rate. This technique appears to be indicated for patients with chronic respiratory failure whenever dyspnoea is not adequately reduced by oxygen given through a nasal tube.

External biliary drainage, the "routine" manner of terminating surgery on the common bile duct, should now become almost obsolete as new methods for operation and exploration during surgery are perfected. A review of cases receiving biliary surgery over a period of 20 years showed that external biliary drainage was conducted in only 4 p. cent of operations on the common bile duct (excluding biliodigestive anastomoses). External biliary drainage should be employed only after due reflection : trans-cystic drainage, the "minor" form, will be indicated less and less as investigational methods during operation develop, while Kehr's drain, the "major" form, will occupy a limited but necessary place in certain cases, primarily in angiocholitis.