Place de ta vitamine D, du sevelamer et du cinacalcet dans la prise en charge des patients en insuffisance rénale [Treatment of secondary hyperparathyroidism in renal insufficiency: role of calcitriol, sevelamer and cinacalcet]

Along with the decrease in kidney function arises a secondary hyperparathyroidism, which constitutes one of the most important risk factor for mortality in patients suffering from renal insufficiency. Treating secondary hyperparathyroidism is challenging, as most of the parameters of mineral metabolism are interconnected. We review here the pathophysiology and treatment options of this entity.

Protocole pour l'évaluation et la prise en charge des plaies chroniques [Protocol for the evaluation and treatment of chronic wounds in the home care setting]

In 2001, it became evident that the domiciliary care nurses needed a tool to assist them in treating patients with chronic wounds. A protocol was therefore developed which could be used not only by the nurses but also by doctors and other health care professionals working in home care. As a parallel measure, a network of nurses specialised in wound care and available for advice and consultation was established.

Prise en soins de la schizophrénie chez la personne âgée

Care of the elderly schizophrenic patient : Despite the development of new aetiopathological models the treatment of late-life schizophrenia is still based essentially on antipsychotic medication. The absence of research specifically targeting late-life schizophrenics limits the value of recommendations on indication, dosage and treatment alternatives, particularly as the latter have scant regard for the age of schizophrenia onset (early, late, very late onset), for the various comorbidities and the polymedication so common in the elderly. The use of atypical neuroleptics at adapted doses should be combined with biopsychosocial care and treatment of psychiatric and somatic comorbidities. The choice of an adapted treatment is often conditioned, especially if early schizophrenia is con sidered, by many years of treatment and side effects which may limit compliance when the evolution itself has been unfavourable with persistent, sometimes handi capping residual symptoms. Moreover, schizophrenia is complicated by cognitive disorders for which the best therapeutic approach in the elderly remains uncertain.

Diagnostic et prise en charge des douleurs de la région scapulaire [Diagnosis and treatments of scapular pain].

Shoulder pain is one of the most common reasons for bone and joint consultations in general practice. In most situations, it is due to a lesion of the rotator cuff. A detailed history can often exclude a cervical or visceral origin of the pain. A full clinical examination especially active and passive mobility provides a good diagnostic approach. It can be refined by specific clinical tests that must nevertheless be interpreted with caution. The management of pathologies of the rotator cuff does not require imaging immediately. Ultrasound is increasingly recognized as the imaging procedure of choice in most situations. For abarticular shoulder pathologies, therapy is primarily conservative. The exact role of infiltration of steroids remains unclear. Only an acute traumatic rupture of the rotator cuff warrants prompt surgical intervention.

[Voyage en Italie : 1824-1830]. , À San Domenico Maggiore : [élévation du tombeau de Galeazzo Pandono] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 224

[Voyage en Italie : 1824-1830]. , Plan général de la chartreuse de St Martin : [plan général, plan d'un logement de chartreux et détail d'élévation] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 230

[Voyage en Italie : 1824-1830]. , Eglise de S. Philippe de Neri à Naples, sur une Echelle de 0005 P.M. : [plan d'ensemble] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 231

[Voyage en Italie : 1824-1830]. , Musée des Études : [peintures d'un tombeau de Nocera, amphores] : [dessin] / h. L. [Henri Labrouste]

Référence bibliographique : Weigert, 274