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The almost pandemic spread of cannabis among adolescents and young adults, especially in France, justifies the attention given to the consequences, not only acute but also delayed, of this intoxication. In the latter case, epigenetic mechanisms occur. We will first recall various types of epigenetic modifications involving either chromatin histones, mainly methylations or acetylations; either DNA, by methylation of cytosines. Such modifications caused by the tetrahydrocannabinol/THC of cannabis can intervene either at the level of gametes before procreation, or at different points of the life cycle. These epigenetic modifications are associated with an increase in vulnerability to drug addiction, involving dopamine D2 receptors in the nucleus accumbens, overexpression of enkephalin precursor synthesis, modifications of CB1 receptors of endocannabinoids, glutamic acid receptors, GABA receptors, proteins involved in synaptic plasticity ... These changes can also affect immune system, cognitive activities, development of psychiatric diseases, related to disturbances of brain maturation. Cerdulatinib in vivo The knowledge that accumulates in this respect is the opposite of the ambient trivialization of this drug. They impose sending an alert to the public authorities and to the public, especially young people, warning on the risks associated with this drug use and abuse. © 2020 Published by Elsevier Masson SAS on behalf of l'Académie nationale de médecine.Skin tattoos have been used for a long time but their toxicity remains little known to the general public who increasingly resort to these techniques without being informed of the risks involved, infectious, allergic, dermatological, systemic toxic and even ophthalmological. This situation is compounded by the fashion for "whole body" tattoos. This dedicated session is an update on the risks associated with tattoos. © 2020 Published by Elsevier Masson SAS on behalf of l'Académie nationale de médecine.The complications of tattoos are multiple and known for many years. However, their success explains their exponential multiplication in all countries. This confirmed the development of two new complications a localized or remote skin sarcoidosis reaction, as well as the development of clinical and histological uveitis. This is in the context of a delayed hypersensitivity reaction, or a granulomatous reaction. Their prevention, remains rather poorly known. It requires that each tattoo-carrying subject perform a systemic sarcoidosis check-up as well as an ophthalmological investigation in search of possible uveitis. If confirmed, preventive and therapeutic measures will be carried out in emergencies to avoid blindness. These new complications confirm the extreme severity of the use of uncontrolled inks, real toxic and sensitizing mixtures, especially apparently during extensive colorful tattoos. These particularly aggressive colored inks release multiple substances and nanoparticles into the body, not all of which are measured in the medium and long term. © 2020 Published by Elsevier Masson SAS on behalf of l'Académie nationale de médecine.Despite the frequency of psychiatric comorbidities, substance use disorder must be understood as an autonomous pathology due to its own determinants, semiology and possibilities of evolution, either spontaneous or under treatment.The ease of access to multiple synthetic products via the Internet combined with the creativity of chemists are contributing to the emergence of novel practices ranging from chemsex to purple drank.Addictive behaviours result from a combination of individual factors (biological and psychological vulnerability) and contextual factors (availability and triviality of the toxicant in the environment). Other mental disorders are factors of vulnerability to addictive pathology as well as the addictive behaviours can reveal an emotional or psychotic pathology.The physician needs to hear the patient powerlessness hidden behind the craving and propose a therapy that may be chemical (including substitution treatment) and psychological. Most of the time, social support is necessary to correct the desocializing effects of substance use disorder or addictive behaviours. © 2020 Published by Elsevier Masson SAS on behalf of l'Académie nationale de médecine.Continuing medical education (CME) is an obligation in France. The evaluation of professional practices joined in 2004 the obligation to acquire knowledge, becoming the Continuing professional development (CPD) in 2009. Currently, the system is complete definition, organization and validation. However, the individual obligation to validate the CPD has never been applied. The recertification process provided for by the 2019 law will not be operational until 2021, at the earliest. Its essential pillar is CPD. The recertification mission who prepared the law excludes all knowledge verification tests. Recertification is done by promoting the professional career path including, in addition to CPD, a maintained and regular activity, an improvement in the relationship with the patient, taking into account the doctor's health and the absence of undesirable events. Seeing that the French Medical Council oversees the professional skills of physicians, it is the Council that receives the validation of the CPD and will receive that of recertification. © 2020 Published by Elsevier Masson SAS on behalf of l'Académie nationale de médecine.Xanthogranulomatous Cholecystitis (GC) is a rare inflammatory pathology of the gallbladder which so far remains unreported in Pakistan. The aetiology and provocative factors of this form of cholecystitis following the pattern of Xanthogranulomatous inflammation in other visceras remain undetermined. It is a destructive inflammatory process and is difficult to differentiate from malignant entities; usually characterised by lipid laden macrophages and acute or chronic inflammatory cells. It is often discovered on frozen sections later confirmed by permanent sections, as in our case. To the best of our knowledge, this is the first reported case of Xanthogranulomatous Cholecystitis in Pakistan. We hope that documenting the occurrence will lead to more research in this regard.