Primary prevention: co-benefits for health and the environment

 Mathilde Lechat Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

This seminar summary is partly based on the work of Prof. Senn from the University Center for General Medicine and the research team from the University Center for General Medicine, University of Lausanne. Its purpose is to develop the notion of co-benefit for health and the environment. The latter is defined as the simultaneous impact on health and the environment of everyday choices and changes that people can undertake in their own lives (e.g. dietary or mobility choices). Rather than being a theoretical, abstract notion, it can be integrated into our daily practice, as illustrated by the clinical vignette presented in this article.

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Health for life... it is possible and desirable! Or how the concept of positive health can open up new perspectives

 Jean Hermesse Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

Three great challenges are having a huge impact on health: major health inequalities, insufficient recognition of the socio-economic determinants of health, and an ageing population. Despite these well-known realities, our institutions remain focused on curative care based on a negative definition of health (absence of disease). The concept of positive health defines health as the ability to adapt and gain control when facing life’s social, physical, and emotional challenges. With its six dimensions (physical function, mental well-being, meaning of life, quality of life, social participation, and daily functioning), it offers an alternative, global vision of health. This unifying concept encourages the commitment of all players (schools, local authorities, town planners, social services, associations, healthcare professionals, etc.) in concrete projects, some of which have already proved their worth. A few examples are described here.

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Ecological transition strategies: Which initiatives are on the front-line?

 Ségolène de Rouffignac, Sarah De Munck Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

The ecological transition is underway: This movement supporting the evolution towards a new model of society that embraces sustainability and solidarity calls into question our current healthcare system in particular. General medicine is also called upon to make this transition. This article highlights the concrete initiatives that have been put in place to educate, inform, and act in favor of planetary health at the front-line level. This article was presented during the “Teach the Teacher: Challenges and Perspectives” program on October 3, 2022, as part of the “University in Transition”.

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Sustainable development in hospitals: at the roots of bioethics

 Grégoire Wieërs, Laurent Ravez Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

Global crises related to environmental changes are undermining healthcare structures. Yet, the medical practice itself contributes to this situation by responding to a logic of consumption and by indiscriminately generating pollution. To what extent are these behaviors counterproductive by contributing to a global evil? A medical ethic for the future, which would integrate environmental care into the prerogatives of medical practice, seems necessary.

This ethic already exists and is embodied in what for decades has been referred to as “bioethics”. Van Rensselaer Potter considered this discipline to be a necessary wisdom for the use of techniques and knowledge specific to the life sciences, and Fritz Jahr saw it as a moral obligation towards all living beings. However, it is the most pragmatic but also the most individualistic application proposed by André Helleghers and, following him, Beauchamp and Childress that has been retained and widely applicated.

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Prevention of venous thromboembolism in medical patients: What role for fondaparinux (Arixtra®)?

 Cédric Hermans Published in the journal : December 2023 Category : Actualité thérapeutique

Venous thrombotic events (deep vein thrombosis and pulmonary embolism) represent a major complication among hospitalized patients. For a long time, venous thromboembolism (VTE) was the focus of attention during surgical procedures. Today, however, it is among patients admitted for acute or chronic medical conditions that VTE is increasingly raising concerns and interest.

The incidence of VTE in medical patients, its lack of consideration, and insufficient prevention cannot be ignored. Systematic and rigorous assessment of the thrombotic risk in all admitted medical patients and consequent monitoring during their stay is a priority.

While low-molecular-weight heparins (LMWHs) have established themselves as the reference preventive antithrombotic agents, including in medical patients, the pentasaccharide fondaparinux (Arixtra®) represents an attractive alternative.

The properties of this synthetic molecule and its validation in clinical studies should make this anticoagulant a preferred alternative or a first-line agent for VTE prevention in medical patients.

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Innovations in vaccinology

 Julien De Greef Published in the journal : December 2023 Category : Maladies infectieuses

Several new vaccines have recently been developed, some of which are now available on the Belgian market. This article presents an overview of new vaccines against pneumococcus, respiratory syncitial virus, influenza, shingles and dengue fever.

Vaccine advances against malaria are also discussed.

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Voluntary massive elemental mercury poisoning

 Caroline Vincent (1), Thalia de Ruffi (1), Wolfgang Schuller (2), Denis Hers (3), Anne Toussaint (3) Published in the journal : December 2023 Category : Psychiatrie

We hereby report on the case of a 40-year-old patient who used elemental mercury for suicidal purposes by voluntary ingestion of approximately 100 mL. We describe this unusual form of suicide attempt and present the different short- and long-term consequences. We emphasize the need for caretakers to anticipate the collection of disposed mercury, in order to avoid environmental polluting and associated consequences. We also mention the importance of collaboration between somatic physicians and psychiatrists to limit institutional consequences.

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From the trivialization of trauma to its invisibilization, how to prevent post-traumatic stress disorder?

 Claire Mairiaux (1), Sylvain Dal (2) Published in the journal : December 2023 Category : Psychiatrie

Despite the popularization of the mechanisms of psychological trauma and vulgarization of related concepts, this article suggests a form of invisibilization of post-traumatic pathologies and the secondary insufficiency of their management. This article presents different explanations for this invisibilization, as well as concrete avenues for treatment.

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Nitrous oxide intake and neurotoxicity

 Bastien Tossens (1)*, Romane Ponthot (1)*, Sofia Maldonado Slootjes (2), Damien Gruson (1), Vincent Haufroid (1), Joseph P. Dewulf (1), Kevin-Alexandre Delongie (1), Guillaume Grzych (3), Lidvine Boland (1) Published in the journal : December 2023 Category : Biochimie médicale

Nitrous oxide (N2O) is an anesthetic gas, also consumed for its euphoric properties, which can cause serious health problems. In this report, we present the case of a 23-year-old man who has been regularly consuming this gas since 2018, with a progressive intensification of his consumption, leading to subacute myeloneuropathy. Given a similar context, a previous diagnosis of Guillain-Barré syndrome in 2021 is questioned. We review the laboratory tests to be performed in the management of a patient presenting motor and sensory neuropathies associated with N2O consumption, namely homocysteine and methylmalonic acid (MMA) assays.

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Expectations of general practitioners and pharmacists regarding health data communication: a cross-sectional survey in the Wallonia-Brussels Federation

 Florent Guyaux (1), Annick Nonneman (2) Published in the journal : December 2023 Category : Médecine Générale

Objective

This study aims to explore the expectations of pharmacists and general practitioners (GPs) regarding the exchange of medi­cal data via health networks.

Methodology

A quantitative questionnaire study was conducted among pharmacists and general practitioners in the Wallonia-Brussels Federation (FWB). Data were analyzed using descriptive statistics.

Results

The questionnaire yielded a sample of 609 people. Overall, 83% of GPs wanted access to the medication dispensing history, 93% of pharmacists wanted to access the full Summarized Electronic Health Record (SUMEHR), and 62% of GPs favored sharing this SUMEHR with the pharmacists believing it would improve their collaboration and treatment control. However, less than 10% of GPs agreed with sharing more sensitive data such as medical reports or biological results, while 64% of doctors believed the indication for treatment should be shared with pharmacists on an optional basis. More than 70% of GPs and pharmacists preferred to use specific communication tools between themselves.

Conclusion

GPs and pharmacists are looking for health networks to facilitate communication, health data exchange, and access to medication history and patterns. Their underuse can be partially explained by insufficient knowledge of the tools, difficulty of access, bugs, respect for privacy, non-implementation of the tools in business software, time-consuming encoding and fear of judgment of drug prescriptions, or the transfer of the GP’s role to the pharmacist.

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