La Revue du praticien
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This review discusses current therapeutic options for leg ulcers. Compression therapy remains the first-line treatment for venous ulcers, with the use of an external pressure of 30 to 40 mmHg at the ankle (0.8 < ABPI < 1.3). Superficial vein surgery does not improve healing rates of venous ulcers; however it has been shown to reduce ulcer reoccurrence in the context of a competent deep venous system. ⋯ Systemic antibiotics should be considered only if the ulcer presents clinically significant infection (spreading erythema, cellulitis, purulent exudates and fever). Choose a type of dressing depending on the phase of healing and on particulars situations (infection, hemorrhagic, malodorous wounds, dermatitis of surrounding skin). In addition to conventional therapeutic options, patient education and lifestyle interventions should not be forgotten.
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La Revue du praticien · Jun 2010
[Impact of group therapeutic education in the management of adult sleep disorders. Prospective study conducted from September 2007 to March 2008 by a group of general practitioners].
The prescription of hypnotic drugs in the management of adult insomnia is a public health issue. The implementation of a non-pharmacological, therapeutic approach is a daily problem for primary physicians. ⋯ Group therapeutic education in the form of cognitive behavioral therapy performed during a conference results in a change in behaviors and a mid-term improvement in sleep quality in participants.
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La Revue du praticien · Feb 2010
[Screening and early diagnosis of cancers: 2 ways for a same goal].
Early diagnosis is the most efficient way to decrease mortality rate, side effects and sequelae due to cancer. The first step consists in anticipating diagnosis by simultenaously taking into consideration non specific clinical symptoms and risk of cancer estimated by the combination of individual risk factors. Screening is a different way to anticipate diagnosis of cancer. ⋯ Organised cancer screening programs allow quality control, evaluation and efficiency measure of the screening policy. Opportunist screenings as developed in some countries or for particular tumours are decided by practitioners and patients following practice recommendations. Side effects of these approaches have to be kept in mind: overdiagnosis and socio-economic inequalities must be controlled for both opportunistic and organised screenings.