Traitement de l'asthme et de la rhinite durant la grossesse et l'allaitement [Treatment of asthma and rhinitis during pregnancy and breast feeding]

Inhaled therapies are preferred to systemic ones during pregnancy and breast feeding. A real paradox exists however between the necessity to ensure an optimal treatment for pregnant women with asthma, in order to prevent fetal hypoxia, and the precaution linked to any drug prescription during pregnancy. Thus, the use of topical corticosteroids remains the first choice for asthma as well as rhinitis. Inhaled beta2-agonists are also recommended. Systemic corticosteroids may however be prescribed without hesitation when their use is required for asthma treatment. It is also interesting to note that oral second-generation antihistamines are currently allowed during pregnancy and breast feeding. This type of antihistamines is indeed to be preferred to first-generation ones that generate more side-effects and generally are thus not to be prescribed during breast feeding.

Traitement des tumeurs maligne du foie par radiologie interventionnelle: techniques intra-artérielles [Interventional radiology procedures for malignancies of the liver treatment: Intraarterial procedures].

Intraarterial procedures such as chemoembolization and radioembolization aim for the palliative treatment of advanced hepatocellular carcinoma (stage BCLC B and C with tumoral portal thrombosis). The combination of hepatic intraarterial chemotherapy and systemic chemotherapy can increase the probability of curing colorectal cancer with hepatic metastases not immediately accessible to surgical treatment or percutaneous ablation.

Traitement chronique de l'hypertension arterielle par un inhibiteur de l'enzyme de conversion de l'angiotensine. [Chronic treatment of hypertension by an inhibitor of angiotensin converting enzyme]

Captopril, or SQ 14,225 an orally active inhibitor of angiotensin-converting enzyme, produced a significant blood pressure reduction in 26 hypertensives. This new drug, alone or combined with a diuretic, has normalized the blood pressure of the 22 patients on long-term treatment.

Utilité des outils d'aide à la prise médicamenteuse pour améliorer l'adhésion au traitement: revue Cochrane pour le praticien

Cet article présente les résultats de la revue systématique: Mahtani KR, Heneghan CJ, Glasziou PP, Perera R. Reminder packaging for improving adherence to self-administered long-term medications.Cochrane Database Syst Rev. 2011 Sep 7;(9):CD005025. PMID 21901694

L'Ouverture émotionnelle: une nouvelle approche du vécu et du traitement émotionnels

L'Ouverture émotionnelle (OE) est une nouvelle approche théorique et pratique qui s'inscrit dans le domaine du vécu et du traitement des émotions. Le modèle de l'OE se base sur l'évaluation et l'analyse de cinq dimensions élémentaires ancrées dans les théories modernes des émotions (la représentation cognitive des états émotionnels, la perception des indicateurs émotionnels corporels internes et externes, l'expression et la communication des émotions et la régulation des émotions). Ces éléments permettent de caractériser l'affectivité des personnes et de réfléchir ainsi à une prise en charge la plus adaptée possible. Cet ouvrage se veut un véritable guide de la pratique de l'Ouverture émotionnelle tant pour les professionnels de la santé mentale (psychologues, psychothérapeutes...) que pour les étudiants en psychologie. Après une présentation des bases conceptuelles de l'OE et de ses aspects développementaux, les auteurs exposent de façon détaillée les résultats empiriques du modèle dans différents domaines de la psychologie clinique et de la psychologie de la santé (troubles de la personnalité, troubles de la dépendance, troubles anxieux, phobies, troubles somatoformes ou burnout, satisfaction dans le couple, bien-être individuel). Enfin ils fournissent des pistes et conseils pour l'application pratique du modèle de l'OE en intervention psychologique et en psychothérapie. En annexe, le lecteur trouvera l'ensemble des instruments (questionnaires et instruments d'auto-observation), sur lesquels repose le modèle de l'OE et qui sont inédits à ce jour.

Traitement médicamenteux de l'artériopathie périphérique [Medical therapy in peripheral arterial occlusive disease]

Atherosclerotic peripheral arterial disease (PAD) is often asymptomatic. If symptomatic, patients present intermittent claudication, ischemic rest pain or tissue necrosis. The prevalence of PAD increases with age and affects about 2% of patients at 60 years. Patients with PAD have an increased risk of coronary or cerebro-vascular events. Measure of the ankle-brachial index (ABI) allows early detection of asymptomatic patients, and allows early preventive interventions, in order to reduce their cardio-vascular risk. The most important interventions are smoking cessation, normalisation of blood pressure and lipid levels, and introduction of an antiplatelet agent, such as aspirin 75 to 160 mg/d.

Traitement au laser des trous maculaires [Laser treatment of macular holes]

OBJECTIVE: To study a new technic of laser treatment of macular holes. METHODS: 21 eyes with stage II-IV macular hole were treated with Argon-green laser. Pigment epithelium in the area of the hole was whitened with spots of 100-200 microns, 100-300 mW. We expected this treatment to create a cellular proliferation that could close and contract the hole. Follow-up after treatment ranged from 3 to 24 months (mean: 9.3 months). RESULTS: Within one month after treatment, the macular hole was closed in 7 eyes (33%) and partially closed in 5 eyes (24%). The visual acuity increased from 1 to 5 lignes (ETDRS chart) in 9 eyes (43%), it remained the same in 9 eyes (43%) and decreased from 1 to 2 lignes in 3 eyes (14%). CONCLUSION: Laser treatment of macular holes seems to be effective and could be proposed as an alternative to the patients who cannot be operated on by vitrectomy and gas tamponade.