Accès sans prescription aux statines: bénéfique ou délétère. [Over-the-counter statins: benefit or harmful?]

Making statin available over the counter is one of the measures proposed to correct its underuse. Since May 2004, simvastatin 10 mg is sold over the counter in Great Britain. But uncertainties persist concerning the efficacy of statin in primary prevention and at a 10 mg dose. Finally, there is a risk of side effects and drug interactions. Beyond the correction of statin underuse and the hope of coronary heart disease mortality reduction, the British decision highlighted the will to give individuals a sense of responsibility concerning their health and its financial cost. Anyway, the benefit of switching statin from prescription to over the counter should be experimentally evaluated before its introduction.

La place de la psychothérapie dans les soins aux personnes toxicodépendantes

Cet article présente une réflexion au sujet de la psychothérapie destinée spécifiquement aux personnes toxicodépendantes. La prise en charge de ce type de problématiques a longtemps été considérée comme difficile, voire quasi impossible dans une pratique « classique » de la psychothérapie. Après avoir fourni quelques repères épidémiologiques et psychiatriques, cet article aborde la place et les spécificités (par exemple niveau de soin, aménagement du cadre et relation thérapeutique) du travail psychothérapeutique dans les soins proposés à la personne toxicodépendante. This article proposes a reflection about the psychotherapeutic work in the treatment of persons with substance use disorders. For a long time, substance abusers have been stereotyped by mental health practitioners, notably as being unresponsive to psychotherapy. After a brief survey of epidemiological and psychiatric elements, this article tackles the role and the specificities (e.g. level of care, setting and therapeutic relationship) of the psychotherapy practice in the care of patients suffering from substance use disorders.

Comment faciliter la consommation de protéines après un bypass gastrique [How to facilitate protein consumption after gastric bypass?].

After a gastric bypass, covering protein needs is impossible. This deficit is co-responsible for several postoperative complications so it is essential to inform, prepare and train every patient candidate for such an intervention. To increase protein intake, it is important to work on two different aspects: on the one hand on food sources, targeting the richest food and, on the other hand, on food tolerance so that these foods can be consumed. In fact, gastric bypass induces not only a reduction in gastric volume, but also reduces the passage from the stomach to the intestine. Changes in feeding behavior are much needed to improve food tolerance.