Initially considered specific for the severe polytraumatized patients, the concept of damage control (DC) has been extended to the acute medicine domain with a climax attained following recent attacks. As a result, this condition now mobilizes a series of actors from the chain of care.

In the pre-hospital setting, the DC with its requirement of early bleeding control consisting of setting a tourniquet and a pelvic belt has modified the ABC trilogy into C-ABC: "Control hemorrhages first", prior to "Airway - Breathing - Circulation". In the emergency setting, during the "golden hour", the team leader must assume four different tasks: supervise the lifesaving procedures, initiate the massive transfusion protocols, limit any additional workup to the essentials, and schedule the priority of the surgical action order.

In the operating room, the carrying out of interventions aimed at controlling bleeding and microbial contamination, along with tolerating unstandardized parameters except for temperature control upon admission, must be performed in the second hour, the speed of surgery being now the priority. In the ICU, homeostasis restoration within 36 hours should enable a secondary surgical procedure for anatomical and functional purposes to be conducted. At times, maybe even often, several intermediary interventions are necessary in order to perfectly control the hemorrhage and infection prior to undertaking the final surgery.

Glucocorticoids (GC) are used in all medical areas because of their anti-inflammatory and immunosuppressive effects. Their undesirable effects are, however, much feared, in particular cortisone-induced myopathy (CD). This condition is characterized by insidious muscle atrophy, exhibiting an important prognostic role. CD is related to the GC-induced imbalance between muscle protein synthesis and degradation, promoting their degradation yet inhibiting their synthesis. We have herein undertaken a review focused on CD’s main pathophysiological mechanisms, along with a discussion on potential targets, such as myostatin, activin receptor Type IIB, TRAF6, and REDD1. To end with, practical recommendations for the fight against CD have been developed, including resistance exercises.

Complaints of tingling and numbness in the hands are common. These paresthesias are most often indicative of a compressive neuropathy affecting the nerves of the hand. Compression of the median nerve in the carpal tunnel is the most common, followed by compression of the ulnar nerve in the cubital tunnel at the elbow. More rarely, the median nerve is compressed at the arcade of the pronator teres in the forearm and the ulnar nerve in the Guyon’s canal at the wrist. Other compression sites also affecting the radial nerve, mainly under fibromuscular tunnels (distributed from the thoracic outlet to the distal part of the limb), and cervical root compressions may also cause paresthesias. The diagnosis is mainly clinical, but can be complemented by electromyography and ultrasound. The treatment is usually conservative in early stages, consisting in avoiding stress on the nerve and in corticosteroid infiltrations. If symptoms persist, surgical decompression gives good results and prevents sequelae if performed sufficiently early.