[Ordalie, sensation-seeking and impulsivity. Critical analysis of definitions]. / Ordalie, recherche de sensations et impulsivité. Analyse critique des définitions.

BACKGROUND: In the fields of psychology and psychiatry, the use of the terms impulsivity, sensation-seeking and ordalie to refer to risk-taking behaviors can sometimes be confusing. OBJECTIVE: The objective of this study was to establish a clinical definition of the concepts of ordalie, sensation-seeking and impulsivity, in order to analyze the similarities and differences between these concepts. METHODS: We prioritized literature review articles with or without meta-analysis from the Medline database and supplemented with the Google-Scholar database. The articles were included in this review if their objectives were in line with ours. The research was conducted in November 2018. RESULTS: Twenty-seven articles were selected. There are similarities in the clinical definitions of these concepts with measurable heterogeneous constructions, and an exacerbation in adolescence for engagement in harmful behaviors, but there are also nuances that highlight their differences. CONCLUSION: We were able to describe areas of divergence and convergence between these three concepts but not to establish a quantitative diagram of the areas of divergence and convergence. It would seem that the coexistence of sensation-seeking and impulsivity in the same individual could explain that individual's involvement in ordalique behaviors. Further studies approaching this hypothesis would seem useful in terms of preventing risk-taking behaviors such as addictive behaviors.

[Which indications for inpatient admission of a patient with an addiction? Application of the chronic disorders model. A face validity study]. / Quelles indications d'hospitalisation d'un patient avec addiction ? Application du modèle des pathologies chroniques. Une étude de validité apparente.

INTRODUCTION: The medical identification of an addiction (use disorder) often results in inpatient admission with a view to its definitive suspension. However, for other chronic diseases, inpatient admission is indicated for specific situations and the objective is not the definitive suspension of the chronic disease. Our goal was to clarify addiction as a chronic disease and to determine explicit indications for inpatient admission. METHOD: Three-stage face validity study: (1) from the analysis of consensual definitions, search by the subset theory whether addiction can be considered as a chronic disease; (2) Develop generic indications for inpatient admissions based on the analysis of chronic disease care pathways validated by the HAS (French Health Agency) and apply them to addiction; (3) Validate by Delphi expert consensus method the determined indications. RESULTS: Step (1) showed that the definition of addiction allowed to include it in that of chronic disease. Step (2) determined 7 indications for inpatient admission of a patient with a chronic disease, and its application to addiction identified 15 indications for inpatient admission of a patient with addiction. In step (3), the Delphi method yielded consensus on 14 of the 15 indications. CONCLUSION: By clarifying addiction as a chronic disease, we were able to determine 14 indications for inpatient admission of a person with an addiction and to distinguish them from the long-term care of addiction. These explicit indications can help the general practitioner or community psychiatrist to better manage patients with addiction on the basis of their expertise with chronic diseases management.

[Is involuntary commitment to treatment applicable in case of an addictive disorder in the French context? A critical review of available evidence]. / Les soins sans consentements peuvent-ils s'appliquer en cas d'addiction dans le contexte français ? Une analyse critique des données.

OBJECTIVE: The objective of this work was to determine whether compulsory psychiatric treatment is applicable in France to patients with an addiction. To this end, several questions were formulated, at the legislative level and in terms of professional recommendations. Our secondary objective was to analyse those practices epidemiologically and in terms of evaluating their impact. METHODS: Using the PRISMA method for systematic research, documents were selected from the following databases: regulatory (Legifrance), scientific societies [High Authority for Health (HAS), French Society of Emergency Medicine (SFMU), French Society of Alcohology (SFA)]; concerning our secondary objective (epidemiological and evaluative) documents from several data bases [Public Health Database (BDSP), Psy Health Foundation, EM-Premium, Pubmed] were reviewed. RESULTS: The search retrieved 163 documents, of which 13 were included based on examination. Legislative texts and professional recommendations do not exclude involuntary commitment to treatment in case of an addictive disorder. Epidemiological data describe use disorder as one of the most mentioned disorders in cases of involuntary commitment to treatment, with clinical improvement as long as treatment lasts. CONCLUSION: French law does not prohibit compulsory addiction treatment in psychiatry. Compulsory addiction treatment could be an access to health care for some patients and an emergency measure to limit at one point the accumulation of damage or in view of a life-threatening situation.

Prevention of iron deficiency in preterm neonates during infancy.

The preterm infant inevitably develops iron deficiency unless supplementary iron is given. Oral iron supplementation is preferred in ideal social circumstances but, where compliance with such therapy is uncertain, intramuscular iron dextran may be a more effective treatment. A study was conducted to compare the effectiveness of two methods of preventing iron deficiency of prematurity. One group of healthy premature infants was given oral iron 2 mg/kg/d until the age of 6 months. The second similar group was given 100 mg as intramuscular iron dextran (Imferon; Fisons) between the ages of 6 and 8 weeks. Both kinds of supplementary iron appeared to have benefited the majority of infants in this trial.

Prevalence of rickets at the age of 12 months. A study of appropriately developed for gestational age but premature infants.

A prospective study to determine the prevalence rates of rickets, as determined by clinical, biochemical and radiological examinations performed at the age of 12 months in preterm infants of low birth weight and full-term control infants of mothers in lower socio-economic classes, was carried out. Clinical rickets was suspected in 5 cases. Biochemical and/or radiological evidence of rickets was not evident in any of the infants studied, although 4 infants showed radiological evidence of osteopenia. Serum alkaline phosphatase and 25-hydroxycholecalciferol levels showed significant seasonal variations. Serum zinc and copper levels were within normal ranges for age. The true prevalence rate of rickets during infancy among the prematurely born or full-term infants in Cape Town is not known. The findings of our study show that as long as the mother utilizes the available community health services her infant should not develop nutritional rickets by the age of 12 months.