Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg最新文献

This is the report on the case of a 74 year old male patient who was admitted to hospital emergency because of a distended bladder, which was detected on an MRI. This MRI was performed because of an acute paralysis of the patient’s left leg. After various examinations we could conclude that the patient’s neurological symptoms were not due to metastases of a solid tumour as we expected, but to a primary spinal diffuse B-cell lymphoma. The central nervous system, and especially the spinal cord, are an extremely rare location for primary B-Cell lymphoma.

Regular practice of physical activity (PA) has many health benefits in both healthy individuals and in people with non-communicable diseases (NCDs). In order to disseminate this evidence and to strengthen the promotion of PA in people with NCDs, the Sport-Santé project was created in Luxembourg and officially launched in April 2015. In 2014, a stocktaking of the different organizations offering PA for people with NCDs was realized in order to develop the Sport-Santé project. Different communication tools were used to promote Sport-Santé as well as the aforementioned organizations. The present study aimed to re-evaluate the offers of PA for people with NCDs in Luxembourg one year after the launch of the project. The organizations offering PA for people with NCDs (orthopaedics, obesity and overweight, neurology and rare diseases, oncology and cardiology) were screened in 2014 and in 2016. The number of weekly offered hours of PA for people with NCDs were collected and the participation rate was observed. Participants (192 in 2014 and 196 in 2016) volunteered to answer a survey, which contained questions regarding their age, sex, time since enrolment, travel distance, former and current PA participation, and type of recruitment. Additional items regarding prescription and refund were explored only in 2016. In 2016, more than 55 hours per week of PA were offered for people with NCDs in Luxembourg (≈44 hours per week were identified in 2014). However, this increase was not statistically significant. No difference was observed between 2014 and 2016 regarding the participation rate (2014: 8.9 ± 5.1 participants per hour; 2016: 8.4 ± 5.7 participants per hour). Participants were younger in 2016 than in 2014. The time since enrolment was shorter in 2016 than in 2014. No difference between 2014 and 2016 was observed for travel distance, sex distribution, former and current PA participation, and type of recruitment. Participants were mainly recruited by the healthcare professionals. More than 69 % of the participants would like to receive a medical prescription for the PA. Fifty-two percent of the participants would appreciate a refund of the participation fees by their health insurance. The increasing efforts of Sport-Santé and the organizations offering PA for people with NCDs lead to increase the offer. However, the participation rate remains unchanged. The decrease in age and in time since enrolment observed in 2016 could be explained by the creation of new activities, a larger participant's turnover or high number of withdrawals among long-term participants. Even if participants are mainly recruited by healthcare professionals, this type of recruitment can be attributed to very few idealists. All healthcare professionals should be aware of the offers of Sport-Santé and advise their patients to participate in a PA program. It is now time to advance the idea of prescription of PA as a privileged treatment option and to convince the policymakers to

After an outline on the hypocrisy of the Catholic Church towards jewish doctors,the author list some arguments to explain why Jewish doctors were that soughtafter. He then concentrates on the situation in Luxembourg - on indigenousdoctors and migrants, finishing with a parallel between asylum seekers fromyesterday and today.

Background: The benefits of cardiac rehabilitation are well accepted. However, there still remains a debate concerning the risk of cardiac events, especially arrhythmias, during exercise training. The goal of the study was to retrospectively analyze events, including arrhythmias, in the cardiac rehabilitation unit of the Centre Hospitalier de Luxembourg during 2014-2015 and to identify if there was a link between patients stratified as high-risk patients and events.

Methods: This analysis included each patient that participated in cardiac rehabilitation at the Centre Hospitalier de Luxembourg during 2014 and 2015. Major and minor cardiac events during exercise training in this period were retraced by retrospectively looking at patient files. These events were related to the potential risk of the patients, assessed by the "Risk stratification for cardiac events", edited by the American Association of Cardiovascular and Pulmonary Rehabilitation.

Results: 628 patients were recruited for cardiac rehabilitation at the Centre Hospitalier de Luxembourg during 2014 and 2015. They exercised for a combined total of 15065 training hours. There were no major cardiac events during exercise training in this period; the number of minor events was low (n=24; 1 minor event/628 training hours). About two thirds of our patients are considered as low risk patients, one third of the patients were at intermediate or high risk. We found no relationship between events and risk stratification.

Conclusion: There were no major cardiac events in our patients and the rate of minor cardiac events was low and not related to risk stratification.

Our study set out to monitor all admissions admitted to an oncology ward overa period of 60 days between 20/10/14 and 18/12/14. We wanted to analyse thereasons for admission, in order to identify treatment related complications andother preventable causes for inpatient admission.

The diagnosis of neurocognitive disorders such as mild cognitive impairments and dementia is a challenging endeavour. On behalf of the neuropsychologists of the Luxembourgish Society of Psychology (SLP), the authors develop a common framework for the neuropsychological diagnosis of dementia in the Luxembourgish context (NP-DiaDem) and promote the role of the neuropsychologist in this process. The paper's aim is threefold: (I) highlighting the role of the neuropsychological evaluation to support the medical diagnosis of neurodegenerative cognitive disorders; (II) providing recommendations for the neuropsychological assessment, based on recently published international guidelines; and (III) providing a new diagnostic process, facilitating the differentiation between mild and more severe states of cognitive decline. An important heterogeneity in the evaluation of cognitive performances and assessments instruments exists, partly due to the multicultural and multilingual context of the population living in Luxembourg. Prior applying the present recommendations, a note on the specific Luxembourgish context is provided as it influences directly the diagnostic process. The absence of validated and culturally adapted assessment tools for the Luxembourgish context is a serious problem in the diagnosis of cognitive deficits of either origin. The taskforce therefore strongly recommends and supports the development of a large database of cognitive performance data and hence population-specific norms for some of the most basic diagnostic tools.

Benzodiazepine hypnotics bear a higher risk of high dose dependence thanbenzodiazepine anxiolytics, according to a recent study in Luxemburg. Thisarticle summarizes the main indications of these molecules and the currenttreatment recommendations. It provides an overview of public health actions ofthe past and the future to reduce their excessive consumption.

Over a short period of one month we undertook a systematic review of allmedications of our residents in the nursing home. Prior to this we examined thepatients with great care and where necessary, laboratory tests or other furtherinvestigations took place. By the end of this procedure, we analysed themedications prescribed and on the recommendations of the program Stopp andStart, several adaptations were done. In summary, some medications increased,mainly for osteoporosis prevention and some other could be reduced, mainlythe psychotropic drugs. A systematic review for patients in nursing homes, twicea year seems sufficient for the adaptations of chronically used medications.Psycho-Geriatric patients - Medications - Stopp and Start programme.

The psychological and neuropsychological characteristics of gifted children andadolescents are analysed, as well as the emotional and behavioural risks linkedto this condition.A prospective follow-up study of N=93 highly gifted students suffering fromschool failure at the beginning of adolescence was implemented. They weretreated with an integrated form of music psychotherapy and verbal psychotherapyin 5 separate groups. The methodology of treatment combined active musicalimprovisation with the writing of stories or the production of drawings undermusical induction, followed by verbal elaboration in the cognitive-psychodynamicpsychotherapeutic tradition.The evaluation was based on a mixed-methods design, combining psychometricscales, projective tests and expressive tests. Comparative pretest-posttest,correlational and multidimensional analyses were computed, using non-parametricstatistical procedures adapted to small samples and data belonging to a mixedlevel of measurement. We present a meta-analysis of the confirmatory results in5 subgroups.There was a significant increase in the capacity of concentration, the capacityof imaginary and symbolic elaboration, the pictorial and literary creativity,self-esteem, the quality of coping strategies, as well as in school marks. Therewas a significant decrease in defensive functioning and in embitterment andresignation. The latent dimensions extracted with Optimal Scaling proceduresfrom the correlational matrixes of the Delta values of TAT and TSD-Z weremeaningful at the light of the state-of-the-arts.The results of the study confirm a prior theoretical modelization coming out ofthe preparatory stage of the research project. They are interpreted at the light ofrecent findings in developmental and clinical psychology of adolescence and theyopen many tracks for future research.