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Ehlinger M.,University of Strasbourg | Brinkert D.,University of Strasbourg | Besse J.,University of Strasbourg | Adam P.,University of Strasbourg | And 2 more authors.
Orthopaedics and Traumatology: Surgery and Research | Year: 2011

The incidence of femoral fracture on hip prosthesis is increasing. Plate fixation is the method of choice when the prosthesis is stable. In fracture with proximal extension, the quality of the bone fixation is critical and, despite the development of anatomic plates, may be endangered when there are too few proximal screws. To resolve this issue, we recommend using a reversed LCP™ anatomic distal femoral Less Invasive Stabilization System (LISS™) locking plate: e.g., a left distal femoral plate for femoral fracture on right-hip implant. This presents several advantages: minimally invasive surgery, the introduction of the plate being facilitated by the LISS™ ancillary; ease of locking, also thanks to the ancillary; and, above all, multiple proximal trochanteric fixation thanks to the form of this anatomic distal LISS™ plate, improving proximal bone fixation. The present technical note seeks to illustrate the interest of using a " reversed" plate, in terms of simplicity of fitting and quality of reduction and consolidation, while also specifying the associated limitations and tolerance. © 2011 Elsevier Masson SAS. Source


Alvarez V.,Hopital du Valais | Alvarez V.,University of Lausanne | Alvarez V.,Harvard University | Rossetti A.O.,University of Lausanne
Journal of Clinical Neurophysiology | Year: 2015

Neurophysiology is an essential tool for clinicians dealing with patients in the intensive care unit. Because of consciousness disorders, clinical examination is frequently limited. In this setting, neurophysiological examination provides valuable information about seizure detection, treatment guidance, and neurological outcome. However, to acquire reliable signals, some technical precautions need to be known. EEG is prone to artifacts, and the intensive care unit environment is rich in artifact sources (electrical devices including mechanical ventilation, dialysis, and sedative medications, and frequent noise, etc.). This review will discuss and summarize the current technical guidelines for EEG acquisition and also some practical pitfalls specific for the intensive care unit. © Copyright 2015 by the American Clinical Neurophysiology Society. Source


Krahenbuhl T.,Service DOncologie Hematologie | Portmann L.,Service dendocrinologie | Anchisi S.,Hopital du Valais
Revue Medicale Suisse | Year: 2012

The emergence of the new targeted therapies has revolutionized the management of several cancers. We take a special interest in the standard management of all thyroid cancer, except the anaplasic variant. Based on two clinical cases, we examine the place of tyrosin kinase inhibitors in unusual, refractory, situations, i.e. iodine-refractory or metastatic cancer. The ideal medical approach implies a multidisciplinary teamwork. Source


Coutaz M.,Hopital du Valais
European Geriatric Medicine | Year: 2014

Increased life expectancy, which reflects progress in living conditions, medical knowledge and technology, has given rise to an aging of the population. Thus, the number of older subjects requiring care has increased. As a result, the resources that modern state must devote to healthcare are increasing, directly affecting the cost of health insurance premiums to taxpayers. This has resulted in a certain social stigma surrounding medical costs of older persons, causing them to feel insecure and guilty, sometimes to the point where they forgo care or even envisage assisted suicide, lest they become an economic burden on their loved ones. Explicit rationing of access to care or reimbursement of medical services does not seem to globally reduce healthcare costs (reduction of outpatient costs, but a strong increase in hospital costs). Therefore, an ethical approach established equitably and knowingly through shared decision-making by clinicians and patients could consent to omitting certain diagnostic procedures or onerous and futile care, thereby, contributing, in parallel, to restricting increases in health costs. © 2013 Elsevier Masson SAS and European Union Geriatric Medicine Society. Source


Therapeutic hypnosis: a relational art using attention with the intention to treat. The definition of hypnosis most commonly formulated nowadays by practitioners does not adequately meet the threefold demands of the patient's nformed consent, express formulation of the caregiver's intentions, and demonstration of the therapy's efficacy. This common definition of therapeutic hypnosis needs updating, to enable the therapists who offer it to their p atients to adjust their relational aptitudes to the scientific, deontological and ethical needs of the contemporary therapeutic relationship. On the basis of semantic, comparative and ethical considerations, this article concludes on a definition of medical and therapeutic hypnosis founded on current knowledge of attention and therapy, adapted to the demands of the psychothera-peutic context specific to contemporary society. Source

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