La Revue du praticien
-
The practice of anaesthesia is surrounded by the same legal texts as in other medical fields and by a decree, which is specific to it. This decree notably prescribes a preliminary consultation by an anaesthetist, in a lapse of time allowing change to eventually the planned strategy or to optimise preoperative care. It is therefore important that all medical data useful to the patient assessment should be available at this time. ⋯ It should be noted that the development of such standards aims first at improving patient's care. Claims reduction could be consider as a secondary consequence. Other means of improving our practice deserve to be developed, such as national confidential surveys.
-
Mitochondrial and metabolic myopathies constitute a group of disorders characterised by abnormal muscular metabolism of energy. Most of these disorders are genetically transmitted. Recent progress in the field has led to spectacular advances in their classification and the understanding of the mechanisms involved, particularly in mitochondrail myopathies. ⋯ Acute episodes of rhabdomyolysis on effort can occur, with an attendant risk of renal failure. Mitochondrial myopathies have multi-organ manifestations and muscular involvement is not always at the forefront. Although diagnosis may be suggested by clinical factors, it should be confirmed by teams and laboratories that specialize in muscular disorders.