Pharmacogenetic Guidelines for Psychotropic Drugs: Optimizing Prescriptions in Clinical Practice.

The modalities for prescribing a psychotropic (dose and choice of molecule) are currently unsatisfactory, which can lead to a lack of efficacy of the treatment associated with prolonged exposure of the patient to the symptoms of his or her illness and the side effects of the molecule. In order to improve the quality of treatment prescription, a part of the current biomedical research is dedicated to the development of pharmacogenetic tools for individualized prescription. In this guideline, we will present the genes of interest with level 1 clinical recommendations according to PharmGKB for the two major families of psychotropics: antipsychotics and antidepressants. For antipsychotics, there are CYP2D6 and CYP3A4, and for antidepressants, CYP2B6, CYP2D6, and CYP2C19. The study will focus on describing the role of each gene, presenting the variants that cause functional changes, and discussing the implications for prescriptions in clinical practice.

Traum'cast: an online, open-access educational video podcast series for teaching military trauma care to all healthcare providers.

The aim of this paper was to describe the development of 'Traum'cast', an ambitious project to create a high-quality, open-access, 12-week video podcast programme providing evidence-based continuing medical education for civilian and military healthcare practitioners dedicated to the management of trauma caused by weapons of war. The management of such patients became a particular public health issue in France following the 2015 terrorist attacks in Paris, which highlighted the need for all healthcare professionals to have appropriate knowledge and training in such situations. In 2016, the French Health General Direction asked the French Military Medical Service (FMMS) to create a task force and to use its unique and considerable experience to produce high-quality educational material on key themes including war injuries, combat casualty care, triage, damage control surgery, transfusion strategies, psychological injury and rehabilitation. The material was produced by FMMS and first broadcast in French and for free, on the official FMMS YouTube channel in September 2020. Traum'cast provides evidence-based continuing medical education for civilian and military healthcare practitioners. Traum'cast is an educational innovation that meets a public health requirement.

[Military psychiatry in a theatre of operations: on mission in Mali]. / Psychiatre militaire sur un théâtre d'opérations: en mission au Mali.

The recent missions of military psychiatrists in the theatres of operation underline the reactivity of the French healthcare system, focused on the expertise of the combat unit doctor. Operation Serval in Mali illustrates in particular the methods of medical-psychological support in exceptional situations, across a vast geographical area and in very difficult climatic conditions. The concept of "forward psychiatry" has a particularly important role to play in the early screening and treatment of psychological disorders in order to preserve the operational capacity of the deployed personnel.

Ejection in hostile environments: medico-psychological aspects for the fighter pilot.

INTRODUCTION: In the French Air Force, commitment of fighter squadrons in Afghanistan revives the fear among pilots of being ejected in a hostile environment, along with the prospect of being captured. CLINICAL OBSERVATIONS: Although ejection in a hostile environment is an exceptional event, it is what flight crews fear most strongly over enemy territory. Since the widespread use of ejection seats in fighter aircraft in the 1950s, ejection has become a means of protecting the crews' lives. Ejection is a breaking point when the pilot suddenly passes from an intense activity to a passive position in which he (or she) is often helpless and sometimes exposed to the hostility of the environment where he lands. It is always important to analyze the circumstances surrounding an ejection. Some clinical observations allow us to understand the psycho-traumatic potential of this brutal experience. In a hostile environment, ejection quite rapidly becomes a question of survival. DISCUSSION: The pilot is technically and physically prepared during training. He (or she) regularly trains for the use of the ejection seat and the equipment to protect himself, to report, and ensure his survival until his recovery. Because it is always a singular event, on a case-by-case basis, no psychological reaction to such a situation can be modeled with a view to predicting psycho-traumatic disorders. CONCLUSION: Since 2007, there has been a medico-psychological supporting device, organized by the French Air Force, to be used after this type of event.