B Acad Nat Med Paris
-
B Acad Nat Med Paris · Jun 2020
Review[Recreational use of cannabis: from effects to harm Epidemiological data].
As the medical use of so-called "therapeutic cannabis" is in the process of being approved in France, the opening to its recreational use is the next logical step, as it has been always the chronology followed in all countries. Indeed, those who have legalized the drug have previously approved its therapeutic use. This "justifying a project phase" stage seems unavoidable. ⋯ Estimated at 12.7% in 1992, it reached 44.8% in 2017. Moreover, 25% of users in the year aged from 18 to 64 years old were at high risk of problematic use or dependence in 2017. This figure is worrying because it is constantly increasing; it affects 3% of 18-64-year-old, just over a million people.
-
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.
-
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.
-
The practice of tattoo is developing more and more all over the world. Infections are known. but chronic inflammatory reactions have often resulted in a variety of clinical manifestations. In addition to allergic reactions, non-allergic reactions prevail in black tattoos and manifest themselves as "papulonodular" lesions. ⋯ Other aetiologias than pigment are evoked, such as the role of an infectious agent, but to date none has been identified, a particular genetic terrain remains to be defined. Systemic localizations being possible, the extension assessment is important to carry out. It is also important, as a preventive measure, that subjects and their treating physician be informed of the potential risk associated with these drugs indicated for specific serious pathologies.
-
Dementias, and Alzheimer's disease (AD) in particular, will increasingly become a public health issue. However, three major data may change the severity of these pathologies: in young adults, simple measures of healthy lifestyle (control of vascular risk factors, physical activity and cognitive stimulation), have an impact on a future cognitive decline; the same lifestyle interventions may delay the start of the disease for elderly people potentially at-risk; finally, and for the first time, a monoclonal antibody directed against amyloid lesions has just shown a significant effect on the progression of AD in patients at an early stage of the disease. According to these results, we will have to reconsider the strategy for managing minor or severe cognitive disorders and particularly AD. ⋯ The solution is to act earlier, even preventively. It is necessary to improve a care offer adapted to this new situation in order to impact on the disease as soon as possible, even before the onset of symptoms, based on: 1) predictive algorithms aimed at establishing whose cognitively unimpaired individuals may further develop the disease; these algorithms will be based on demographic, family, cognitive, genomic and biological data, such as in the "Santé Cerveau" project developed in partnership with the Health Regional Agency (ARS) and the general practitioners; 2)and on some expert centers which must become "dementia prevention clinics" to test prevention measures, initiate and validate multi-domain therapeutic education programs; to disclose about the risk in response to the request of worried patients; and to propose early pharmacological treatments if these individuals are on the way to declare AD in the coming months, taking into account competition between risks. This will allow to prepare to make use of new pharmacological treatments that might be discovered.