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Book Description
Introduction : le syndrome de l'intestin irritable (SII) est un motif fréquent de consultation en médecine de ville, et sa prise en charge peut parfois s'avérer complexe par le médecin généraliste. Les recommandations internationales les plus récentes conseillent l'utilisation d’une méthode de diagnostic positive ainsi que le recours aux probiotiques et au régime sans FODMAPs. L'objectif de cette étude a été d'analyser les pratiques diagnostiques et thérapeutiques des médecins généralistes concernant la prise en charge des patients atteints du SII, étant donné l'absence de recommandations officielles françaises. Matériel et méthode : étude observationnelle descriptive : un questionnaire comprenant 18 questions a été envoyé aux médecins généralistes installés libéraux en activité du département de l'Aisne dans les hauts-de-France, après accord téléphonique, durant la période du 1er juin 2023 au 27 juillet 2023. Résultats : parmi les 347 médecins sélectionnés, 186 ont accepté de participer à l'étude et 65 réponses exploitables ont été obtenues. Concernant le diagnostic du SII, 69,2 % des médecins généralistes interrogés ont déclaré réaliser au moins un examen complémentaire. Les examens les plus réalisés étaient la biologie sanguine (67,7 %), la tomodensitométrie abdomino-pelvienne (32,3 %) et l'échographie abdomino-pelvienne (29,2 %). 33,9 % des médecins interrogés ont estimé la coloscopie comme indispensable au diagnostic. Les traitements de première ligne les plus utilisés étaient les antispasmodiques (73,8 %), les laxatifs osmotiques (72,3 %), les probiotiques à visée régulatrice du transit (64,6%) et les pansements digestifs à base d’argile (63,1%). Ces traitements étaient jugés comme modérément efficaces par la majorité des médecins interrogés. Les antidépresseurs inhibiteurs sélectifs de la recapture de la sérotonine étaient peu utilisés (12,3 %) en tant que traitement de seconde intention, les anxiolytiques leurs étant préférés (38,5 %). 76,9 % des médecins interrogés déclaraient utiliser des probiotiques et 56,9 % déclaraient conseiller un régime sans FODMAPs. Conclusion : la prise en charge du SII par les médecins généralistes de l'Aisne correspond aux recommandations les plus récentes, bien qu'un tiers d'entre eux semble appliquer une méthode de stratégie diagnostique d'exclusion et que les anxiolytiques soient préférés aux antidépresseurs en tant que traitement de seconde intention. L'utilisation du régime sans FODMAPs et le recours aux probiotiques semblent acceptés en pratique courante.
Book Description
Introduction : le syndrome de l'intestin irritable (SII) est un motif fréquent de consultation en médecine de ville, et sa prise en charge peut parfois s'avérer complexe par le médecin généraliste. Les recommandations internationales les plus récentes conseillent l'utilisation d’une méthode de diagnostic positive ainsi que le recours aux probiotiques et au régime sans FODMAPs. L'objectif de cette étude a été d'analyser les pratiques diagnostiques et thérapeutiques des médecins généralistes concernant la prise en charge des patients atteints du SII, étant donné l'absence de recommandations officielles françaises. Matériel et méthode : étude observationnelle descriptive : un questionnaire comprenant 18 questions a été envoyé aux médecins généralistes installés libéraux en activité du département de l'Aisne dans les hauts-de-France, après accord téléphonique, durant la période du 1er juin 2023 au 27 juillet 2023. Résultats : parmi les 347 médecins sélectionnés, 186 ont accepté de participer à l'étude et 65 réponses exploitables ont été obtenues. Concernant le diagnostic du SII, 69,2 % des médecins généralistes interrogés ont déclaré réaliser au moins un examen complémentaire. Les examens les plus réalisés étaient la biologie sanguine (67,7 %), la tomodensitométrie abdomino-pelvienne (32,3 %) et l'échographie abdomino-pelvienne (29,2 %). 33,9 % des médecins interrogés ont estimé la coloscopie comme indispensable au diagnostic. Les traitements de première ligne les plus utilisés étaient les antispasmodiques (73,8 %), les laxatifs osmotiques (72,3 %), les probiotiques à visée régulatrice du transit (64,6%) et les pansements digestifs à base d’argile (63,1%). Ces traitements étaient jugés comme modérément efficaces par la majorité des médecins interrogés. Les antidépresseurs inhibiteurs sélectifs de la recapture de la sérotonine étaient peu utilisés (12,3 %) en tant que traitement de seconde intention, les anxiolytiques leurs étant préférés (38,5 %). 76,9 % des médecins interrogés déclaraient utiliser des probiotiques et 56,9 % déclaraient conseiller un régime sans FODMAPs. Conclusion : la prise en charge du SII par les médecins généralistes de l'Aisne correspond aux recommandations les plus récentes, bien qu'un tiers d'entre eux semble appliquer une méthode de stratégie diagnostique d'exclusion et que les anxiolytiques soient préférés aux antidépresseurs en tant que traitement de seconde intention. L'utilisation du régime sans FODMAPs et le recours aux probiotiques semblent acceptés en pratique courante.
Author: Nathan I. Cherny Publisher: Oxford University Press, USA ISBN: 0199656096 Category : Medical Languages : en Pages : 1281
Book Description
Emphasising the multi-disciplinary nature of palliative care the fourth edition of this text also looks at the individual professional roles that contribute to the best-quality palliative care.
Author: Richard Hain Publisher: Oxford University Press ISBN: 019882131X Category : Medical Languages : en Pages : 535
Book Description
The importance of palliative care for children facing life threatening illness and their families is now widely acknowledged as an essential part of care, which should be available to all children and families, throughout the child's illness and at the end of life. The new edition of the Oxford Textbook of Palliative Care for Children brings together the most up to date information, current knowledge, evidence, and developments of clinical practice in the field. The book is structured into four sections. 'Foundations of Care' describes core issues, the foundations on which paediatric palliative care is based. 'Child and Family Care' looks at different aspects of psychological, social, and cultural care for the sick child or young person, and their family. These chapters cover the time course of the illness, around the time of death and support for the bereaved family. 'Symptom Care' focuses on the uses of medication, specific symptoms, and their management. Finally, 'Delivery of Care' examines practical approaches to care in different environments and the needs of clinicians. Two new editors join the team from Canada and South Africa, reflecting our aims to contribute towards the development of care for children across the world, and to be a resource for both experienced clinicians and those new to the field. Comprehensive in scope, exhaustive in detail, and definitive in authority, this third edition has been thoroughly updated to cover new practices, current epidemiological data, and the evolving models that support the delivery of palliative medicine to children. This includes two new chapters, looking in detail at 'Decision Making' and 'Perinatal Care', and a new section highlighting the emerging importance of 'Palliative Care for Children in Humanitarian Crises'. This book is an essential resource for anyone who works with children worldwide.
Author: John E. Helzer Publisher: American Psychiatric Pub ISBN: 1585627690 Category : Medical Languages : en Pages : 289
Book Description
Among today's astounding research discoveries, perhaps the most fascinating is the mapping of the human genome and its implications for a vastly improved understanding of how genes affect our physiology and behavior. With that understanding comes a critical need to establish a diagnostic taxonomy for psychiatric illness that is more precise but still clinically relevant. This volume responds to that need. It highlights the shortcomings of current categorical diagnoses, such as those used in DSM-IV, for future research needs in behavioral disorders in general and psychiatric genetics in particular. With a chapter by each distinguished neuroscientist who presented at the 2000 American Psychopathological Association (APPA) meeting, this volume is divided into four sections: Definitional Tensions, which discusses the difficulties with the current categorical diagnostic system; Imaging Psychopathology, which presents research demonstrating how imaging technologies can tremendously improve our illness definitions; Longitudinal Studies, which details what we can learn from epidemiological and other longitudinal studies; and Exploring Alternatives, which discusses the application of dimensional classification systems in genetics research in psychopathology, with a fascinating chapter on using new methodologies for treating subsyndromal or pre-schizophrenia, a taxonomic condition defined herein as "schizotaxia." This unique collection represents a significant step in developing approaches to classification that will lead to more accurate diagnoses and treatments for patients and a broader range of taxonomic options for researchers. As such, it will also be welcomed by psychiatric clinicians and educators, as well as by anyone interested in genetics and how it governs human behavior.
Author: Claus D. Buergelt Publisher: John Wiley & Sons ISBN: 0470962844 Category : Medical Languages : en Pages : 565
Book Description
Color Atlas of Equine Pathology offers a practical guide to identifying equine diseases, presenting a single resource with more than 1000 images showing predominantly gross pathology. Organized by body systems, the book allows for picture matching during or after an equine necropsy. In this user-friendly atlas, each chapter takes a common format, presenting the disease process as well as congenital, degenerative, inflammatory, and neoplastic sequences, with text boxes offering quick reference to key information. The book begins with an introductory chapter summarizing the principles of the equine field necropsy, and subsequent organ-based chapters depict gross features of disease, focusing on macroscopic digital images supplemented by histology and immunohistochemistry when necessary. Some clinical information for correlation with pathology is included. Color Atlas of Equine Pathology is an essential resource for diagnostic veterinary pathologists and pathology residents, as well as for equine practitioners performing necropsies in the field.
Author: Massimo Cuzzolaro Publisher: Springer ISBN: 3319908170 Category : Medical Languages : en Pages : 437
Book Description
This book equips readers with the knowledge required to improve diagnosis and treatment and to implement integrated prevention programs in patients with eating and weight disorders. It does so by providing a comprehensive, up-to-date review of research findings and theoretical assumptions concerning the interface and interactions between body image and such disorders as anorexia nervosa, bulimia nervosa, binge eating disorder, other specified feeding and eating disorders, orthorexia nervosa, overweight, and obesity. After consideration of issues of definition and classification, the opening part of the book examines the concept of body image from a variety of viewpoints. A series of chapters are then devoted to the assessment of the multidimensional construct “body image”, to dysmorphophobia/body dysmorphic disorder, and to muscle dysmorphia. The third part discusses body image in people suffering from different eating disorders and/or overweight or obesity, and two final chapters focus on body image in the integrated prevention of eating disorders and obesity, and cultural differences regarding body image. The book will be of interest to all health professionals who work in the fields of psychiatry, clinical psychology, eating disorders, obesity, body image, adolescence, public health, and prevention.
Author: Huguette Glowinski Publisher: ISBN: Category : Psychology Languages : en Pages : 248
Book Description
Jacques Lacan (1901-81) was one of the most original and controversial thinkers of the post-war period. His ideas had a profound effect on the intellectual movements of his time and his work is of continuing importance to a wide range of disciplines: psychoanalytic theory and practice, literary criticism, critical social theory, linguistics, cinema, art criticism and political science. Lacan's ideas can, however, be notoriously difficult: convoluted, idiosyncratic, arcane, and almost always obscure! A Compendium of Lacanian Terms provides students of Lacan with a clear and helpful exposition on some 40 key terms. Each entry outlines the conceptualization of the idea, locating it within Lacanian discourse, and the evolution of the term within the development of Lacan's ideas. A list of references is provided at the end of each entry. The editors' brief essay-like descriptions of key Lacanian terms are a superb idea, much needed in both academic and clinical arenas of psychoanalytic world. - Choice - Jan 2002
Author: Justin Amery Publisher: ISBN: 0199567964 Category : Family & Relationships Languages : en Pages : 448
Book Description
Childen's palliative care has developed rapidly as a discipline, as health care professionals recognize that the principles of adult palliative care may not always be applicable to children at the end of life. The unique needs of dying children are particularly evident across Africa, where the scale of the problem is overwhelming, and the figures so enormous that they are barely comprehensible: over 400,000 children in Africa died from AIDS in 2003, and out of the 166,000 children a year diagnosed with cancer, 85% of these are in the developing world. Despite the enormous need, provision of children's palliative care in Africa is almost non-existent, with very few health workers trained and confident to provide care for dying children. The challenges of providing palliative care in this setting are different to those in more developed countries, contending with the shortage of physical and human resources in addition to the vast scope of the care needed. Written by a group with wide experience of caring for dying children in Africa, this book provides practical, realistic guidance by improving access to, and delivery of, palliative care in this demanding setting. It looks at the themes common to palliative care--including communication, assessment, symptom management, psychosocial issues, ethical dilemmas, end of life care, and tips for the professional on compassion and conservation of energy--but always retains the focus on the particular needs of the health care professional in Africa. While containing some theory, the emphasis is on practical action throughout the book. Children's Palliative Care in Africa provides health care professionals working in Africa, and other resource-poor settings, with the confidence, knowledge, and capacity to improve care for the terminally ill child in constrained and demanding environments.
Author: Hugh MacPherson (Ph. D.) Publisher: ISBN: 9780443050497 Category : Medical Languages : en Pages : 482
Book Description
Written by THE leading lights in the field of integrating acupuncture into a Western medical system, this book bridges the gap between the theoretical foundations of acupuncture and its application in a modern Western clinical context. Each case history focuses on the complexities and dilemmas of treatment that are tackled, providing valuable insights by experienced practitioners into the management of a course of acupuncture treatment.
Author: Guillaume Gest
Author: Guillaume Gest
Author: Nathan I. Cherny
Author: Richard Hain
Author: John E. Helzer
Author: Claus D. Buergelt
Author: Massimo Cuzzolaro
Author: Huguette Glowinski
Author: Justin Amery
Author: Hugh MacPherson (Ph. D.)
Author: Ohio Hospice and Palliative Care Organization Staff