B Acad Nat Med Paris
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The complications of tattoos are multiple and known for many years. However, their success explains their exponential multiplication in all countries. This confirmed the development of two new complications: a localized or remote skin sarcoidosis reaction, as well as the development of clinical and histological uveitis. ⋯ If confirmed, preventive and therapeutic measures will be carried out in emergencies to avoid blindness. These new complications confirm the extreme severity of the use of uncontrolled inks, real toxic and sensitizing mixtures, especially apparently during extensive colorful tattoos. These particularly aggressive colored inks release multiple substances and nanoparticles into the body, not all of which are measured in the medium and long term.
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B Acad Nat Med Paris · Jun 2020
Review[Complications of tattoos: clinical and pathological classification, pathophysiology, particle kinetics].
Tattoos are more and more frequent and their surface is increasing. They are also becoming more and more colorful. ⋯ The long-term effects of the presence of carcinogenic products and nanoparticles justify the carrying out of prospective studies. The public should be made aware of these complications and of the difficulties of tattoo removal.
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The almost pandemic spread of cannabis among adolescents and young adults, especially in France, justifies the attention given to the consequences, not only acute but also delayed, of this intoxication. In the latter case, epigenetic mechanisms occur. We will first recall various types of epigenetic modifications involving either chromatin histones, mainly methylations or acetylations, either DNA, by methylation of cytosines. ⋯ These epigenetic modifications are associated with an increase in vulnerability to drug addiction, involving dopamine D2 receptors in the nucleus accumbens, overexpression of enkephalin precursor synthesis, modifications of: CB1 receptors of endocannabinoids, glutamic acid receptors, GABA receptors, proteins involved in synaptic plasticity… These changes can also affect: immune system, cognitive activities, development of psychiatric diseases, related to disturbances of brain maturation. The knowledge that accumulates in this respect is the opposite of the ambient trivialization of this drug. They impose sending an alert to the public authorities and to the public, especially young people, warning on the risks associated with this drug use and abuse.
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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[Continuing professional development and recertification process in France].
Continuing medical education (CME) is an obligation in France. The evaluation of professional practices joined in 2004 the obligation to acquire knowledge, becoming the Continuing professional development (CPD) in 2009. Currently, the system is complete: definition, organization and validation. ⋯ The recertification mission who prepared the law excludes all knowledge verification tests. Recertification is done by promoting the professional career path including, in addition to CPD, a maintained and regular activity, an improvement in the relationship with the patient, taking into account the doctor's health and the absence of undesirable events. Seeing that the French Medical Council oversees the professional skills of physicians, it is the Council that receives the validation of the CPD and will receive that of recertification.