The old anesthetic ketamine has demonstrated interactions with the inflammatory response. This review intends to qualify the nature and the mechanism underlying this interaction. For this purpose, preclinical data will be presented starting with the initial works, and then, the probable mechanisms will be discussed. A summary of the most relevant clinical data will be presented. In conclusion, ketamine appears as a unique "homeostatic regulator" of the acute inflammatory reaction and the stress-induced immune disturbances. This is of some interest at a moment when the short- and long-term deleterious consequences of inadequate inflammatory reactions are increasingly reported. Large-scale studies showing improved patient's outcome are, however, required before to definitively assert the clinical reality of this positive effect.

Transfusion refusal expressed by Jehovah's Witnesses has always been questioning for medical community. However, abundant literature exists treating about how to manage difficult medical bleeding situations in Jehovah's witnesses, there is a few information available on the legal and ethical aspects of transfusion refusal. Since 1994, Europe has putted a spotlight on patient's right. The question of patient's autonomy and consent have taken a predominant place in care. In order to summarize the actual situation in Europe, this work intends to draw a global view on legal, ethical and medical aspects of transfusion refusal expressed by Jehovah witnesses.