Search

Introduction Chronic kidney disease (CKD) is correlated with the incidence of DFU. Furthermore, the International Working Group on the Diabetic Foot (IWGDF) has proposed a classification of the risk factors for diabetic foot ulcer (DFU). The purpose of this study was to investigate the relationship between the IWGDF risk classification and the GFR level estimated by the CKD-EPI formula. Methods We conducted a prospective multicentric study. Patients were recruited from either diabetology or nephrology departments. The secondary objectives were to determine this relationship after excluding people on dialysis and to identify the factors associated with podiatric risk. Results Four hundred and eighty-six patients were included, with a mean age of 64.2 years (±15.7) and a mean diabetes duration of 15.7 years (±12.1). Based on the IWGDF classification, 53.5% of the population were in podiatric stage 0, 11.7% in stage 1, 34.8% in stage 2 or 3. The mean GFR level was significantly lower in patients with podiatric risk ≥ 2 (36.8 ± 33.9 ml/min/1.73m2 vs 71.9 ± 35.3 ml/min/1.73m2, P Conclusion GFR levels are linked to podiatric stages in diabetes mellitus. Patients with GFR

Interventional radiology techniques provide excellent local tumor control for small tumors in various organs, but several limitations can hamper the oncological outcomes such as the tumor size or the number of lesions. Technical improvements, optimal patient selection and combination with systemic therapies, including immune checkpoint inhibitors, have been successfully developed to overcome these barriers. In this setting, chemotherapy and targeted therapies aim to diminish the tumor burden in addition to local treatments, while immunotherapies may have a synergistic effect in terms of mechanism of action on the tumor cell as well as the immune environment, with multiple treatment combinations being available. Finally, interventional Rrdiology treatments often increase tumor antigen exposure to the immune system, and thus stimulate a specific antitumor immune response that can act beyond the treated site. Notwithstanding their many benefits, combination treatment may also result in complications, the most feared may be auto-immune-related adverse events. In early studies, several combined therapies have shown promising levels of safety and efficacy, particularly in hepatocellular carcinoma. This review provides a comprehensive and up-to-date overview of results of combined therapies for primary and secondary liver malignancies. Recent advances and future perspectives will be discussed.

Resume Si les personnes avec une insuffisance renale chronique terminale et vivant en situation d’obesite ont un pronostic considerablement ameliore par la transplantation renale, elles sont encore confrontees a de nombreux freins a l’acces a la greffe. L’effet de l’obesite sur la survie du greffon et la survie toutes causes est de moins en moins demontre. Les questions sur la gestion des immunosuppresseurs, des diabetes post transplantation et des syndromes d’hyperfiltration glomerulaire restent, cependant, toujours un enjeu. Neanmoins, la barriere principale est celle du geste chirurgical. Les complications operatoires restent un frein a l’inscription sur liste. Parallelement, les programmes d’amaigrissement en dialyse avant inscription se confrontent a la surmortalite des cohortes. La question de la chirurgie bariatrique pour les personnes avec les IMC les plus importants peut etre une solution qui doit encore etre consolidee. Les programmes de reentrainement physique en dialyse sont aussi des pistes de recherche clinique dont l’exploration doit se poursuivre. Enfin, L’arrivee du robot pour la chirurgie pourrait permettre de lever certaines barrieres. Ces notions chirurgicales nous amenent, par ailleurs, a nous demander si l’IMC est le bon indicateur. Le tour de taille, reflet du tablier abdominal, n’est-il finalement pas l’element bloquant du chirurgien ? Quoi qu’il en soit, la Haute Autorite de Sante ne fixe, aujourd’hui, une limite a la transplantation renale que pour des IMC au-dessus de 50 kg/m2. Cette regle est encore loin d’etre une realite pour les personnes vivant en situation d’obesite en France et dans le monde.

International audience; Aim: The link between social deprivation and the development of diabetic foot ulcer (DFU) is still widely debated. The study objective was to evaluate the relationship between lower limb amputation, social deprivation level, and inequalities in access to care service among people with DFU. This regional pilot study was conducted at the living area level and based on the French National Health Data System (SNDS).Methods: We conducted a retrospective cohort study using hospital and primary care claim data in the Languedoc-Roussillon region. DFUs were determined using an original algorithm of care consumption or hospital diagnosis. The primary end point was amputation at 1 year. Secondary end points were mortality at 1 year and impact of potential access to care on amputation.Results: We included 15,507 people from 2015 to 2017. Amputation and mortality rates were 17.5 and 117 per 1000 person-years. The least precarious living areas showed better prognoses (relative risk = 0.46; 95% CI 0.27–0.66). Territorial accessibility to a private-practice nurse, unlike physician accessibility, was associated with better results on major outcomes (p = 0.004).Conclusion: This is the first study using SNDS to study the care pathway of DFU management within and outside the hospital. High social deprivation in a living areas seems to be associated with more major amputations after a DFU

During the Covid-19 epidemic, many countries imposed population lockdown. This study aimed to analyse diabetic foot ulcer (DFU) evolution of outpatients between the lockdown period and 1 month after its end.We conducted a prospective, observational, single-centre study without modification of care. All patients who followed up for a DFU in the study centre between 15 April 2020 and 11 May 2020 were included. The baseline assessment occurred 4 weeks after the beginning of lockdown and the follow-up visit 4-6 weeks after easing of lockdown. The primary analysis was based on the Site, Ischaemia, Neuropathy, Bacterial infection, Area, Depth (SINBAD) classification.Twenty-seven patients were included, median 69.4 years, and 25 were followed-up at easing of lockdown. The median SINBAD score was 2 (interquartile range 1; 3) at inclusion and 1 (1; 2) at easing of lockdown, with a mean change of -0.32 (95% confidence interval -0.93; 0.29). Seventy-two percent of the population had a stable or improved score between the two visits. The proportion of patients using off-loading footwear was higher among those whose SINBAD score improved compared to those whose score worsened or remained stable (72%, 44% and 28%, respectively). Diabetes type was linked to DFU prognosis. Five patients (20%) were hospitalized during the follow-up period.Lockdown appears to have had a positive effect on DFU if patients remain under the care of their expert wound centre. We believe this effect is related to better compliance with offloading. The wide use of tele-medicine seems relevant for the follow-up of DFU.

Background Percutaneous CT-guided biopsy of lung nodules is an established method with high diagnostic accuracy but a high rate of pneumothorax and chest tube insertion compared with endobronchial methods. Purpose To investigate the effect of a protocol combining patient positioning biopsy-side down, needle removal during expiration, autologous blood patch sealing, rapid rollover, and pleural patching (PEARL) on complication rate after percutaneous CT-guided lung biopsy, especially chest tube insertion. Materials and Methods In a secondary analysis of both prospectively and retrospectively acquired data from December 2019 to November 2020, consecutive participants underwent biopsy with use of the PEARL protocol (prospective data) and were compared with patients who underwent biopsy at the same tertiary cancer center according to the standard method without any additional techniques (controls, retrospective data). Patient demographics, lesion characteristics, intraprocedural data, complications, and histologic results were recorded and compared. Results One hundred patients in the control group (mean age ± standard deviation, 63 years ± 12; 61 men) and 100 participants in the PEARL group (mean age, 64 years ± 12; 48 men) were evaluated. No differences were found in patient and lesion characteristics. The emphysema rate was 47 of 100 patients (47%) in both groups. The rate of pneumothorax was 37 of 100 patients (37%) in the control group versus 16 of 100 (16%) in the PEARL group (

Cement leakages in soft tissues are a common occurrence during cementoplasty. They may cause chronic pain, and thus treatment failure. Spindle malposition during reinforced cementoplasty may cause vascular, nerve or cartilage injury. Our goal was to evaluate the rate of cement leakage/spindle extraction and describe the techniques used.This retrospective monocentre study included 104 patients who underwent reinforced cementoplasty and 3425 patients who underwent cementoplasty between 2012 and 2020. Operative reports and fluoroscopic images were reviewed to identify extraction attempts and their outcomes.Six patients (5.8%) had a malpositioned spindle, and all of them underwent spindle extraction during reinforced cementoplasty, with an 80% success rate. A total of 7 attempts were performed, using 2 different techniques. One thousand one hundred thirty patients (32%) had a cement leak in soft tissues, and 7 (0.6%) underwent cement leakage extraction during cementoplasty, with a 100% success rate. A total of 10 attempts were performed, using 3 different techniques. No major complication related to the extraction procedures occurred.Spindle malpositions and soft tissue cement leakages are not uncommon. We described 5 different percutaneous techniques that were safe and effective to extract spindles and paravertebral cement fragments.• Soft tissue cement leakages or spindle malpositions are a non-rare occurrence during cementoplasty, and may cause technical failure and/or chronic pain. • Most soft tissue cement fragments and malpositioned spindles can easily be extracted using simple percutaneous techniques.

Diabetic foot ulcer (DFU) and chronic kidney disease (CKD) are 2 significant complications of diabetes mellitus (DM). Up to 40% of patients with DM are expected to also develop CKD, and 19% to 34% will suffer from DFU during their lifetimes. However, data on the link between podiatric risk and the extent of CKD are scarce. Neuropathy, a key element of the International Working Group on the Diabetic Foot (IWGDF) classification, nevertheless appears to be related to the CKD stage. The incidence of DFU and its poor evolution also appear to be linked to the stage of CKD, with mortality reaching its peak in patients with end-stage renal disease (ESRD). Whatever, the decrease in the rate of diabetic foot amputation observed worldwide, especially for major amputations, is also observed in patients with ESRD. Specific actions taken for patients undergoing dialysis seems to improve the DFU prognosis. CKD and DFU share a number of elements of pathophysiology, the first of which is peripheral arterial disease (PAD). Uremic neuropathy and nutritional status also seem to create a link between the development of the 2 complications. This literature review provides an update on the complex and dynamic relationship between DFU and CKD. It examines the epidemiologic link between CKD and diabetic foot risk, CKD and DFU occurrence, and CKD and DFU prognosis. It focuses on the pathophysiological links between these 2 complications. Finally, it highlights the actions taken to improve management in the ESRD population that have reduced the rate of major amputations in this population by more than half.

Introduction: Diabetes is the leading cause of non-traumatic lower limb amputation and end-stage renal disease (ESRD). Monitoring of the risk of diabetic foot wounds is guided by the recommendations of the International Working Group for Diabetic Foot (IWGDF), in particular through the gradation of the podiatric risk. Although chronic kidney disease (CKD) is a known risk factor for diabetic foot wounds, the relationship between CKD stage and IWGDF foot risk grade has never been explored. The purpose of the study was to analyze the relationship between CKD stage and foot grade according to IWGDF 2019. Materials and Methods: We conducted a bi-centric cross-sectional study. All patients were recruited from Diabetes or Nephrology outpatient’s clinic. Foot risk gradation was established during the consultation. Renal function was estimated based on a recent biologic workup. Results: We included 250 patients between November 2019 and August 2020. Podiatric risk grade was associated with stage of renal failure (p Conclusion: There is an association between podiatric risk grade and stage of CKD. This link is dominated by the impact of dialysis. There is interest in strengthening collaborations between dialysis centers, Nephrologists and diabetic foot expert centers with enhanced therapeutic and prevention education programs. A clearance of 30ml/min/1.73m2 appears as a relevant alert threshold to predict a podiatric risk grade 2 or 3. Disclosure J. Bonnet: None. I. Szwarc: None. A. Avignon: None. S. Jugant: None. A. Sultan: None.

International audience; The diabetic foot ulcer (DFU) is a common and serious complication of diabetes. There is also a strong relationship between the environment of the person living with a DFU and the prognosis of the wound. Financial insecurity seems to have a major impact, but this effect can be moderated by social protection systems. Socioeconomic and socio-educational deprivations seem to have a more complex relationship with DFU risk and prognosis. The area of residence is a common scale of analysis for DFU as it highlights the effect of access to care. Yet it is important to understand other levels of analysis because some may lead to over-interpretation of the dynamics between social deprivation and DFU. Social deprivation and DFU are both complex and multifactorial notions. Thus, the strength and characteristics of the correlation between the risk and prognosis of DFU and social deprivation greatly depend not only on the way social deprivation is calculated, but also on the way questions about the social deprivation−DFU relationship are framed. This review examines this complex relationship between DFU and social deprivation at the individual level by considering the social context in which the person lives and his or her access to healthcare.

Aggressive vertebral hemangiomas usually exhibit extraosseous expansion that can result in spinal cord or radicular compression.1 In symptomatic cases, treatment by alcohol embolization and percutaneous vertebroplasty has been reported as feasible, safe, and effective with long-term benefits on neurological symptoms.2 Safety rules before vertebral alcohol embolization include preoperative spinal cord vascularization mapping and opacification through bone needles to assess the absence of dangerous intratumoral anastomoses.In video 1 we present a case of a symptomatic T2 aggressive vertebral hemangioma with dangerous anastomoses between the lesion and both supreme intercostal arteries (SIAs). Embolization by the arterial route of both SIAs was performed, which required good anatomic knowledge of the spinal cord vascularization at the cervicothoracic junction3 4 as a cervical radiculomedullary artery arose from the left costocervical trunk which also fed the left SIA. After occlusion of all dangerous arterial anastomoses, we were able to successfully perform T2 alcohol embolization and percutaneous vertebroplasty.Video 1Case presentation

International audience

Aims/hypothesis This is an update of the results from the previous report of the CORONADO (Coronavirus SARS-CoV-2 and Diabetes Outcomes) study, which aims to describe the outcomes and prognostic factors in patients with diabetes hospitalised for coronavirus disease-2019 (COVID-19). Methods The CORONADO initiative is a French nationwide multicentre study of patients with diabetes hospitalised for COVID-19 with a 28-day follow-up. The patients were screened after hospital admission from 10 March to 10 April 2020. We mainly focused on hospital discharge and death within 28 days. Results We included 2796 participants: 63.7% men, mean age 69.7 ± 13.2 years, median BMI (25th–75th percentile) 28.4 (25.0–32.4) kg/m2. Microvascular and macrovascular diabetic complications were found in 44.2% and 38.6% of participants, respectively. Within 28 days, 1404 (50.2%; 95% CI 48.3%, 52.1%) were discharged from hospital with a median duration of hospital stay of 9 (5–14) days, while 577 participants died (20.6%; 95% CI 19.2%, 22.2%). In multivariable models, younger age, routine metformin therapy and longer symptom duration on admission were positively associated with discharge. History of microvascular complications, anticoagulant routine therapy, dyspnoea on admission, and higher aspartate aminotransferase, white cell count and C-reactive protein levels were associated with a reduced chance of discharge. Factors associated with death within 28 days mirrored those associated with discharge, and also included routine treatment by insulin and statin as deleterious factors. Conclusions/interpretation In patients with diabetes hospitalised for COVID-19, we established prognostic factors for hospital discharge and death that could help clinicians in this pandemic period. Trial registration Clinicaltrials.gov identifier: NCT04324736 Graphical abstract

Introduction et but de l’etude La prevalence de la denutrition en pediatrie est de 15–20 % en milieu hospitalier mais y est largement sous diagnostiquee [1] . Jusqu’a present, il n’y avait aucun consensus national sur les criteres a utiliser en pediatrie. L’evaluation portait sur un faisceau d’arguments permettant a l’equipe soignante d’orienter son diagnostic. En 2019, la HAS a propose des recommandations pour uniformiser ce diagnostic [2] . L’objectif de l’etude etait d’evaluer la difference de prevalence de la denutrition selon les criteres de la HAS par rapport a la methodologie anterieure. Materiel et methodes Nous avons mene une etude prospective sans modification de la prise en charge aupres des patients hospitalises en pediatrie au CHU de Montpellier. L’etude a obtenu l’aval du comite d’ethique du CHU de Montpellier (IRB-MTP_2020_07_202000546). Les criteres d’inclusion etaient : âge [3] . Pour les anciens criteres nous avons retenu la perte de poids involontaire associee a la perte d’un couloir sur les courbes d’IMC et de poids [4] . Resultats et analyse statistique ( Tableau 1 ) Cent trente-six enfants ont ete inclus (F/G : 46 %/54 %). Les taux bruts de denutrition etaient sensiblement les memes selon les deux methodes (50,74 % vs 46,32 %). Toutefois, 24 % des enfants de plus de 2 ans changent de diagnostic (p-value Conclusion Meme si les taux bruts ne changent pas, nous notons une discordance des diagnostics selon les criteres retenus. Les signes cliniques et anthropometriques, notamment l’integration de la notion de perte de poids volontaire, expliquent les passages de non denutris a denutris severe. Pour conclure, avec l’inclusion de nouveaux parametres dont la notion d’etiologie, la HAS donne une nouvelle definition de la denutrition par rapport aux outils utilises en pratique jusqu’alors. Enfin, ces nouveaux criteres permettent une standardisation du diagnostic.

Actes du colloque du 9 juin 2009 ; organisé par le Centre d'études et de recherches constitutionnelles et politiques de l'Université Toulouse 1 Capitole

The European Union and the Council of Europe had since their creation particular relationships. These relationships had known real evolution for sixty years. Espacially, we notice a process of formalisation of these relationships, in order to create an accurate scope of cooperation between European Union and the Council of Europe, as demonstrate several agreements between the European institutions. Some informal tools had been use, or merely created, so that manage these profuse relationships, which had shown a variable efficacy. As a resulte, we observe the necessary uphildong of informal and spontaenous relationships, which aren’t come out of a defined scoop, but from fact situation, from an interpretive or legitimiation needs or in order to overcome a system deficiency,getting in an other. Moreover, the european judge is one of the most important stakeholder of the european relationships, especially when there isn’t any management rule. He creates his own tools and technique, as the Bosphorus presumption of equivalent protection shows. Consequently, is the relationships between the EU and the Council of Europe has to be formalized so as to deepen their cooperation in some areas, formalisation has some limits, as reveales the limited EU accession to the Council of Europe Conventions, and especially the EU accession to the ECHR. The informal relationships, thanks to their spontaneity overcome some complications. A balance is finally found between the need of formalisation and the necessary upholding of informal relationships.; L’Union européenne et le Conseil de l’Europe détiennent depuis leur création des relations particulières. Ces rapports de systèmes européens ont connu une réelle évolution en soixante-dix ans. En particulier, nous avons constaté un processus de formalisation de ces rapports, tendant établir un cadre précis de coopération entre l’Union européenne et le Conseil de l’Europe, comme le démontre les nombreux accords interinstitutionnels entre les institutions des deux Europe. Des outils formels ont également été utilisés, ou tout simplement créés, afin de gérer les rapports de systèmes foisonnants, qui ont démontré une efficacité variable. Entre alors en scène le nécessaire maintien de rapports de systèmes européens informels, spontanés, ne résultant pas d’un cadre prédéfini par les institutions européennes, mais d’une situation de fait, d’un besoin qu’il s’agisse d’un besoin interprétatif, de légitimation ou de pallier la carence d’un système en puisant dans l’autre une règle de droit. Le juge européen est en outre l’un des artisans essentiels des rapports de systèmes européens, notamment lorsqu’en absence de règle générale de gestion, il crée ses propres méthodes de gestion, comme le démontre la présomption de protection équivalente. Partant, si les rapports entre l’Union européenne et le Conseil de l’Europe doivent faire l’objet d’une indispensable formalisation afin d’approfondir leur coopération dans certains domaines, la formalisation a ses limites, comme le révèle le recours largement limité à l’adhésion de l’Union aux Conventions du Conseil de l’Europe, et plus singulièrement les difficultés relatives à l’adhésion de l’Union à la Convention européenne des droits de l’Homme. Les rapports de systèmes informels, par leur spontanéité viennent ainsi pallier certaines raideurs et permettent de traiter des domaines qui ne sont pas couverts par les rapports de systèmes formels. Un point d’équilibre est ainsi trouvé entre un besoin de formalisation et le nécessaire maintien de rapports informels.

International audience

International audience

International audience

International audience

International audience

"Les rapports entre ordres juridiques interpellent les juristes, toutes disciplines confondues. Les interactions normatives que ces rapports suscitent, le mouvement du droit qu'ils enclenchent, interrogent les fondements mêmes de nos cultures juridiques en modifiant en profondeur la structure des ordres juridiques et leurs notions fondatrices. L'idée de Baptiste Bonnet, directeur scientifique de l'ouvrage, a été de faire se rencontrer de nombreux auteurs et membres de juridictions sur un sujet qui transcende les disciplines juridiques, de décloisonner, d'accepter de repenser des notions, de chercher de nouveaux outils et de permettre à la doctrine de porter un regard sur elle-même, sur ses évolutions et in fine sur le droit. Le Traité des rapports entre ordres juridiques se caractérise par la diversité de ses auteurs, 126 au total, ce qui en fait, outre la volonté d'un traitement complet du thème abordé, un ouvrage unique en son genre. L'arborescence des questions soulevées par les rapports entre ordres juridiques méritait un ouvrage qui propose un panorama complet des bouleversements observés, cherche à ouvrir toutes les portes sans a priori et en laissant la place à la liberté d'analyse de la doctrine la plus autorisée dans toute sa diversité. Ce Traité vise à offrir aux juristes un instrument de travail précieux et en même temps un ouvrage qui, par son format assez inhabituel, cherche à célébrer la pensée. [Résumé de l'éditeur]

sur la function de la teorie de l'institution en la creation du droit constitutionnel

International audience

International audience

International audience; L'article propose une réflexion sur la façon dont on peut enseigner les règles concernant les conflits de normes entre ordres juridiques différents

International audience

International audience

International audience

International audience

The legal system in states governed by Islamic law is comprised of a set of heterogeneous rules and principles. Alongside its codified, positive law, religious laws serve as a referential source for the legislature and judiciary. The constitutionalization of Islam as both an official religion and a legislative source in Islamic law states nurtures this legal plurality. The coexistence of these different sources of law, positive and religious respectively, is further accentuated by the subjective variability of law. In this context, the existence of freedom of religion, as enshrined in the constitutions of these Islamic law states, is called into question. The principle of equality without discrimination on grounds of religion; the liberty to freely practice one’s religion; or, indeed, the right to change one’s religion, are framed by legislation or jurisprudence. Although all states have begun the process of constitutionalization, constitutional judges still struggle to assert their autonomy over the executive branch. Islamic law is being exploited by political powers wishing to anchor their authority in religious legitimacy. Nonetheless, encouraging signs of change are evident in the forward-thinking jurisprudence of certain jurisdictions., Le système juridique des Etats de droit musulman est composé de règles et de principes hétérogènes. A côté du droit positif codifié, les règles religieuses constituent une source de référence pour le législateur et pour le juge. La constitutionnalisation de l’islam comme religion officielle et comme source de législation dans les Etats de droit musulman, développe ce pluralisme juridique. La coexistence des différentes sources de droit, positive et religieuse, est accentuée par le système de personnalité des lois. Dans ce contexte, l’effectivité de la liberté de religion proclamée par la Constitution des Etats de droit musulman est remise en cause. Le principe d’égalité sans discrimination fondée sur la religion, la liberté de pratiquer librement sa religion ou encore le droit de changer de religion sont encadrés par la législation ou par la jurisprudence. Bien que tous les Etats aient amorcé le processus de constitutionnalisation, les juges constitutionnels peinent à affirmer leur autonomie par rapport au pouvoir exécutif. Le droit musulman est instrumentalisé par les pouvoirs politiques pour asseoir leur autorité sur une légitimité religieuse. Toutefois, la jurisprudence avant-gardiste de la Haute Cour constitutionnelle égyptienne qui a affirmé son indépendance et la jurisprudence civile des tribunaux tunisiens qui ont interprété l’article 1er de la Constitution tunisienne, sont le signe encourageant d’un changement possible.

Within a multiplicity of European systems for the protection of fundamental rights, the one established by Community law and then by the European Union stands out by its specific construction.Faced with the reluctance of national constitutional courts, the provisions of the original treaty making also shows a significant weakness in terms of protection of fundamental rights, the Court of Justice has established a policy of jurisprudence in order to protect them through a progressive reading of the provisions of the Community Treaty and the European Union. The general principles of law instrument was, for the judge, dominating to specifically define and protect fundamental rights in the Community legal order and then the European Union. Inspired by the constitutional traditions common to the Member States and international legal instruments which the first is the European Convention on Human Rights, the Court of Justice has thus developed a protection of fundamental rights that is all together effective and accepted by the Member States. Today, this protection of fundamental rights is boosted by the prospect of adhesion of the European Union to the European Convention on Human Rights. Therefore, in a context of cross-Europeanization of rights and nesting European legal orders, the Court of Justice of the European Union has been able to draw up a list of argued legal points in order to establish a consistent and harmonious human rights protection which has to be specified.; Dans le cadre d’une multiplicité des systèmes européens de protection des droits fondamentaux, celui établi par l’ordre juridique communautaire puis de l’Union européenne se démarque par la spécificité de sa construction. Face aux réticences des Cours constitutionnelles nationales, les dispositions des traités initiaux faisant montre par ailleurs d’une importante faiblesse en termes de protection des droits fondamentaux, la Cour de justice a établi une politique jurisprudentielle de protection de ces derniers à travers une lecture évolutive des dispositions des Traités communautaires et de l’Union européenne.L’instrument des principes généraux du droit a été, pour le juge, prépondérant pour établir une définition et une protection spécifiques des droits fondamentaux dans l’ordre juridique communautaire puis de l’Union européenne. S’inspirant des traditions constitutionnelles communes aux États Membres et des instruments juridiques internationaux au premier desquels figure la Convention européenne des droits de l’homme, la Cour de justice a ainsi su développer une protection des droits fondamentaux qui soit tout à la fois effective et acceptée par les États membres. Aujourd’hui, cette protection des droits fondamentaux se voit redynamisée par la perspective de l’adhésion de l’Union européenne à la Convention européenne des droits de l’homme. Aussi, dans un contexte d’européanisation croisée des droits et d’imbrication des ordres juridiques européens, la Cour de justice de l’Union européenne a su mobiliser tout un argumentaire juridique pour établir une protection des droits fondamentaux cohérente et harmonieuse qu’il convient de resituer.