La Revue du praticien最新文献

PRACTICAL GUIDE TO ONCOLOGY RADIOTHERAPY. In a medical landscape where physicians, regardless of their specialty, may encounter patients undergoing or having undergone radiotherapy, understanding the intricacies of radiation oncology becomes paramount. This field, essential yet complex due to its technical nature, is the focus of this article, aiming to equip non-specialist doctors with a comprehensive grasp of radiotherapy practices. From initial planning to post-treatment follow-up, the article endeavors to enhance the care quality for radiotherapy patients significantly. It delves into treatment preparation, technical choices, and the significance of tailoring patient care by constantly weighing the benefits and risks. This guide also highlights the importance of long-term follow-up and toxicity management, often in close collaboration between oncologists and primary care physicians, to ensure an integrated approach to cancer treatment.

Treatment of post-traumatic nightmares: THE ROLE OF IMAGERY REHEARSAL THERAPY. Post -traumatic stress disorder develops in 30% of adults exposed to a traumatic event. In these patients, sleep disturbances are the earliest and most persistent symptoms, but they remain relatively unresponsive to the usual treatments used in post-traumatic stress disorder. Post-traumatic nightmares are relivings of the traumatic event and a source of significant emotional distress. They concern over 70% of patients with post-traumatic stress disorder. Imagery rehearsal therapy is the recommended first-line treatment for post-traumatic nightmares. This psychotherapy combines psychoeducational and cognitive restructuring methods where mental imagery is used. According to the literature, imagery rehearsal therapy significantly improves nightmare frequency, insomnia severity, sleep quality and post-traumatic stress disorder symptoms.

WHAT IS THE ASSESSMENT OF THE ETIOLOGY OF THE EPILEPSY? The etiologic assessment carried out in the case of an epilepsy aims to identify the epilepsy syndrome, look for secondary epilepsy, and estimate the risk of seizure recurrence. These different elements are crucial for the therapeutic decision, and for assessing the indication for an antiepileptic treatment. The two key examinations of this assessment are brain magnetic resonance imaging (MRI) and electroencephalogram (EEG). Brain MRI should be performed on a 3 Tesla machine if possible, and must include some specific sequences to be considered of sufficient quality. Its purpose is to search for structural lesions with epileptogenic potential. EEG aims to look for interictal epileptic abnormalities, either focal or generalized, which are of great importance for the identification of the epileptic syndrome. Other investigations may also be useful depending on the patient's history. The results of this assessment must be compared with the clinical data, especially the clinical description of the seizure(s), to achieve the most accurate diagnosis of the epilepsy syndrome.

DRUG REPOSITIONING. Developing new therapeutic agents ("de novo") for human diseases is an increasingly lengthy and costly process, aimed at ensuring patient safety and drug efficacy. An alternative approach, drug repurposing or repositioning, involves using already commercialized or advanced molecules. This strategy offers several advantages, including the availability of extensive data on their safety, efficacy, and potential side effects. Drug repurposing speeds up the early drug development phases and prioritizes molecules for which the outcome on humans is documented. Drug repurposing currently benefits from methodological developments, such as better-annotated databases, the application of advanced algorithms and architectures in the field of AI, and novel physics-based modeling approaches. How is drug repurposing defined, and how much does it impact current drug development pipelines?