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La Revue Du Praticien[JOURNAL]

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[The role of marriage and family counsellors: the example of the Yvelines Sexual Health Centres].

Huynh A, de Gasperi S, Thorin A … +1 more , Dischamps V

Rev Prat · 2026 Jan · PMID 41729646

Facilitating emotional, relational, and sexual education (ERSE) sessions requires expertise, which is possessed by marriage and family counselors (MFC). The Yvelines department has eight public sexual health centers, wit... Facilitating emotional, relational, and sexual education (ERSE) sessions requires expertise, which is possessed by marriage and family counselors (MFC). The Yvelines department has eight public sexual health centers, with a focus on preventive care, health education, and psycho-emotional support. Their team of MFCs leads sessions for 9th grade classes, coordinating with other ERSE stakeholders when possible. The aim is to offer at least one ERSE session to the majority of students in the department in their 9th grade year. These interventions by the department's MFCs follow three main principles: they are free of charge, respectful of each individual and their cultural values, and free of any ideological or religious proselytism. They are carried out in the presence of a member of the local teaching team and follow a codified procedure: after introducing the speaker and the group exchanges' rules, the speaker launches discussions on one or more themes with a view to encouraging students'reflexivity. This activity is facilitated by open-ended questions. The discussed topics are lead by the group and are not imposed by the facilitator, thus respecting the students' level of maturity. After a question-and-answer session, people and places the young can rely on are reminded to them. Topics are numerous and cover biological, psycho-emotional, and legal-social issues. The facilitators have a range of educational tools and group facilitation techniques that can be adapted to each topic and, above all, to each group, depending on their sensitivity and maturity levels, which are jointly assessed by the facilitator and the teaching team.

[Life, death and resurrection of medicines].

Bouvenot G

Rev Prat · 2026 Jan · PMID 41729645

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[Why believe rather than not believe? The supernatural and medicine].

Charlier P

Rev Prat · 2026 Jan · PMID 41729644

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[Influence of age on oncology care].

Rollot Trad F, Pierro M, Mebarki S … +2 more , Paillaud E, Caillet P

Rev Prat · 2026 Jan · PMID 41729643

The management of older adults with cancer represents a major public health challenge due to population aging and the increasing incidence of cancer with age. This management is more complex due to the heterogeneity of o... The management of older adults with cancer represents a major public health challenge due to population aging and the increasing incidence of cancer with age. This management is more complex due to the heterogeneity of older patients, marked by comorbidities, geriatric syndromes, polypharmacy, and frailty that may be exacerbated by anticancer treatments. Despite therapeutic advances, survival among older patients remains lower than in younger individuals, partly due to ageism (limited screening, delayed care, reduced access to innovations, etc.) but also due to frailty (comorbidities, dependence, etc.) that increases with age, requiring a trade-off with cancer in overall management.Frailty assessment is essential to adapt the therapeutic strategy. In geriatric oncology, screening relies in particular on the G8 tool, which helps identify patients who require a comprehensive geriatric assessment (CGA). This assessment provides a multidimensional analysis of functional, mobility, nutritional, cognitive and mood status, comorbidities, and social environment. CGA has diagnostic, prognostic, and interventional value, frequently leading to changes in the initial treatment plan and enabling the implementation of targeted non-oncological interventions.Management should be multidisciplinary, individualized, and dynamic, integrating supportive care, prevention of malnutrition and falls, adapted physical activity, rigorous treatment management, and prevention of iatrogenic complications. Effective communication with patients and caregivers, consideration of the socio-environmental context, and efficient coordination among healthcare professionals are essential to preserve autonomy and ensure the best possible quality of life throughout the care pathway.

[Is geriatric oncology a recognized speciality?].

Droz JP

Rev Prat · 2026 Jan · PMID 41729642

The concept of geriatric oncology came from precursors in the USA and Italy in the late 80th. But it was developed in practice in France from the early 2000th. When the French National Cancer institute was settled, geria... The concept of geriatric oncology came from precursors in the USA and Italy in the late 80th. But it was developed in practice in France from the early 2000th. When the French National Cancer institute was settled, geriatric oncology was considered as a priority and then, financed on the base of the experience of different French physicians and institutions. Rapidly, geriatric oncology programs were implemented and became a national network including oversea regions. Their objectives were: patients' management, research, teaching, and professional and patients' information. An ambitious research trial allowed to validate the G8 screening tool of frailty. Then, France became a pioneer, participating in the international programs within the framework of the Société internationale d'oncologie gériatrique. Nevertheless, there are still important challenges to implement worldwide geriatric oncology activity and to define precisely decision-making processes.

[Systemic treatments in older patients with cancer].

Baldini C, Geiss R

Rev Prat · 2026 Jan · PMID 41729641

The number of older patients with cancer is increasing dramatically. Recently , new anti-tumour therapies have led to significant advances in both curative and metastatic situations, with the arrival of immunotherapies a... The number of older patients with cancer is increasing dramatically. Recently , new anti-tumour therapies have led to significant advances in both curative and metastatic situations, with the arrival of immunotherapies as monotherapy or in combination with chemotherapy or targeted therapies, including antibody-drug conjugates. However, these new treatments have been little evaluated in elderly cancer patients, who are rarely included in therapeutic trials and require numerous adjustments to their intensity due to the increasing underlying frailty associated with age.

[Specificities of oncologic surgery in elder patients].

Peyrottes A, Masson-Lecomte A, Aregui A … +3 more , Meria P, Desgrandchamps F, Mongiat-Artus P

Rev Prat · 2026 Jan · PMID 41729640

The demographic aging and the perpetual increase of cancer incidence in the elderly emphasize the importance of diagnostic and therapeutic specificities within this population. Understanding the concept of frailty, a pot... The demographic aging and the perpetual increase of cancer incidence in the elderly emphasize the importance of diagnostic and therapeutic specificities within this population. Understanding the concept of frailty, a potentially reversible process altering homeostasis, becomes crucial for their management. When diagnosing a localized cancer in an elderly and comorbid patient, the decision for surgical treatment must be collegially discussed after thorough geriatric and anesthetic evaluations. Less invasive alternatives will be systematically explored, in particular organ-sparing strategies. If surgery is fully advocated, the perioperative period must be optimized by the inclusion of patients in Enhanced Recovery After Surgery (ERAS) protocols. Anyhow, chonological age alone should not compromise the principles of oncological surgery but rather encourage an individual-based approach, adapted to patients' physiologies.The particularities of oncological surgery in elderly patients are illustrated here by the example of a bladder tumour infiltrating the muscle.

[Special features of radiotherapy in elderly].

Durdux C, Alati A, Gisselbrecht M

Rev Prat · 2026 Jan · PMID 41729639

Cancer is a disease that predominantly occurs in older patients who represent a quarter of the population in western countries. Numerous types of cancer are observed in elderly people. Radiotherapy is one of the most pow... Cancer is a disease that predominantly occurs in older patients who represent a quarter of the population in western countries. Numerous types of cancer are observed in elderly people. Radiotherapy is one of the most powerful treatments against cancer. Most of published studies have demonstrated feasibility of radiotherapy in curative or palliative intent whatever cancer types are considered. Complete geriatric assessment and a multidisciplinary approach are the key points. The purpose of this review is to highlight sights of radiation oncology specifically related to aging. Particular emphasis is placed on logistic and technical aspects of radiation, as dose, irradiated volume, fractionation and the potential usefulness of new technologies.

[Breast cancer: an example of changing practices that take age-related factors into account. About the ASTER 70s study].

Brain É, Rollot-Trad F, Rochette de Lempdes G … +4 more , Bringuier M, Roque T, Henriques J, Vernerey D

Rev Prat · 2026 Jan · PMID 41729638

According to figures from GLOBOCAN and the European Cancer Information System, nearly 40% of breast cancers occur in women aged 70 and over in France. Breast cancer, the most common cancer in women, has been the subject... According to figures from GLOBOCAN and the European Cancer Information System, nearly 40% of breast cancers occur in women aged 70 and over in France. Breast cancer, the most common cancer in women, has been the subject of several specific studies on the elderly population. As such, it provides numerous examples of the possible and necessary adaptation of strategies according to age, the increased risks of certain treatments, and the efforts to be made with the patients concerned to trigger a participatory reform movement in research, to make it more useful for the growing and already predominant elderly population.  The ASTER 70s clinical study, a phase III randomized trial, illustrate this citizen-led transformation; that addressed the essential question of the benefit of adjuvant chemotherapy for hormone-sensitive (luminal) breast cancer after the age of 70. Published in July 2025 in The Lancet, the public release of this study led to the creation of a national collective to better represent the voices of elderly subjects in cancer research.

[Oncogeriatrics:10 key messages].

Brain E

Rev Prat · 2026 Jan · PMID 41729637

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[Agenesis of the inferior vena cava].

Ennaboulsi Y, Belabbes S, El Aissate M … +3 more , El Khader SE, Moudden MK, Zinebi A

Rev Prat · 2026 Jan · PMID 41729636

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[Unilateral rheumatoid arthritis of the hand].

Nassar K, Zaher S, Ajerouassi A … +2 more , Rachidi W, Janani S

Rev Prat · 2026 Jan · PMID 41729635

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[Pregnancy at an advanced age: risks and monitoring].

Cabanes A, Pinton A

Rev Prat · 2026 Jan · PMID 41729634

Due to various maternal motivations and thanks to the advances in assisted reproductive techniques, the maximum possible age for pregnancy continues to be pushed back. Pregnant women of advanced age represent a new categ... Due to various maternal motivations and thanks to the advances in assisted reproductive techniques, the maximum possible age for pregnancy continues to be pushed back. Pregnant women of advanced age represent a new category within the obstetric population, with distinct characteristics. Indeed, pregnancies achieved at an advanced age carry multiple risks, affecting both the mother and the fetus. These specific risks require adapted monitoring of these women. In the absence of French guidelines, this article concludes by quoting the American recommendations on this subject and highlight the key points of appropriate monitoring to be proposed.

[Myocardial infarction with healthy coronaries].

Akiki T, Spaulding C

Rev Prat · 2026 Jan · PMID 41729633

No significant coronary artery lesion is seen on an emergent coronary angiogram in 5 to 10% of patients with myocardial infarction. These patients are most often female, younger and with less risk factors for atheroscler... No significant coronary artery lesion is seen on an emergent coronary angiogram in 5 to 10% of patients with myocardial infarction. These patients are most often female, younger and with less risk factors for atherosclerotic disease. Causes of myocardial infarction with no significant coronary artery stenosis (MINOCA) include plaque rupture, coronary artery spasm and coronary microvascular lesions. MINOCA is diagnosed using clinical (prolonged chest pain) ECG and biological (rise in troponin) data. A coronary angiogram is mandatory to confirm the absence of significant coronary artery lesion. Endovascular imaging is often performed. Cardiac MRI confirms the diagnosis of myocardial infarction and rules out other causes of prolonged chest pain and rise of troponin such as myocarditis and Takotsubo syndrome. Long term follow-up by a cardiologist is necessary.

[Purpuras in adults and children].

Fain O, Mekinian A, Dubrel M

Rev Prat · 2026 Jan · PMID 41729632

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[The professional values of doctors and other healthcare professionals].

Clause-Verdreau AC

Rev Prat · 2026 Jan · PMID 41729631

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[Latest recommendations from the HAS concerning the use of ethical questioning].

Clause-Verdreau AC

Rev Prat · 2026 Jan · PMID 41729630

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[1215: Separation of medicine and surgery].

Fabiani-Salmon JN

Rev Prat · 2026 Jan · PMID 41729629

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[Urogenital schistosomiasis].

Bellakehal M

Rev Prat · 2026 Jan · PMID 41729628

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[What are the key takeaways from the HAS recommendations regarding special populations (elderly populations and pregnancy or planning to become pregnant) ?].

Bordier L

Rev Prat · 2025 Nov · PMID 41575137

WHAT ARE THE KEY TAKEAWAYS FROM THE HAS RECOMMENDATIONS REGARDING SPECIAL POPULATIONS (ELDERLY POPULATIONS AND PREGNANCY OR PLANNING TO BECOME PREGNANT) ? Type 2 diabetes in elderly patients is a common reason for consul... WHAT ARE THE KEY TAKEAWAYS FROM THE HAS RECOMMENDATIONS REGARDING SPECIAL POPULATIONS (ELDERLY POPULATIONS AND PREGNANCY OR PLANNING TO BECOME PREGNANT) ? Type 2 diabetes in elderly patients is a common reason for consultation in general practice. Its management is challenging due to the heterogeneity of this particular population, which often combines age-related and diabetes-related complications. A geriatric assessment is necessary to set glycemic targets and define the therapeutic strategy. Therapeutic means are based on lifestyle modifications combined with medical treatment with particular attention to the risk of hypoglycemia and malnutrition. The indications for cardio- and nephroprotective treatments are the same as for younger subjects. Regular reassessment of health status is necessary and therapeutic deintensification should be considered when appropriate.
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