Parkinson: towards expanded indications of neurostimulation

Now reserved for advanced Parkinson’s disease forms, neurostimulation demonstrates real benefits at earlier stages of the disease. These results argue in favor of a wider use of this technique. Medical evidence but an economic and organizational puzzle …

Progressive, degenerative neurological disease, Parkinson’s disease is characterized by symptoms such as motor slowness, difficulty in movement, tremors, an uncertain balance and rigidity. It results from the degeneration of nerve cells that produces dopamine, an essential for the control of movements and body coordination neurotransmitter. In France, 150,000 people are affected by the disease, and there are 6 000 to 9 000 new cases per year. The incidence increases with age.


The standard treatment based on medicines antiparkinsonian taken orally (levodopa, dopamine agonists …) that will increase the amount of dopamine in the brain and stimulate the brain regions in which dopamine has an effect. To-onset of the disease, patients see their symptoms disappear, the term ” honeymoon . ” But this period did not last after 4-6 years, an interim period is characterized by the resurgence of the motor and / or dyskinesia (abnormal movements) that reflects a fluctuation of the beneficial effect of treatment conditions. It was during this period that other treatments can be considered as deep brain stimulation . It is estimated that 400 to 500 patients a year benefit. Continue reading “Parkinson: towards expanded indications of neurostimulation”


Who has never heard of Parkinson’s disease? Many famous and patients participated in the mediation of this disease. Rightly, we believe it is limited to tremors. Similarly, treatments and therapeutic strategies often remain unknown. Doctissimo reviews the medications used to treat this disease …

Of unknown cause, Parkinson’s disease is characterized by a weakening of the amounts of dopamine in the brain. This neurotransmitter is essential for communication between nerve cells it. This lack leads to a lack of coordination between different brain areas involved in the control of skeletal muscles, that is to say the so-called voluntary muscles (muscles that are controlled). No treatment to cure the disease exists to this day but it is nevertheless possible to delay its development.

medi-cal definition

Pharmacological point of view, it is possible to increase the amount of dopamine in the brain or to fight against the consequences of its failure on the balance of great pharmacological systems of our body. The drugs used are antiparkinsonian . There are also surgical treatment gives good results in some cases. Continue reading “Antiparkinsonian”

Special pain

Pain is a universal feeling. But in the case of diseases such as AIDS and cancer, it can be particularly challenging. Many campaigns against pain have enabled patients to break the taboo of suffering. But despite improved absorptions, too many patients continue to suffer in silence.

While the treatment and management of pain are constantly being improved, many patients hesitate to share his sufferings to the medical team. In the case of AIDS and cancer pain sometimes appears, wrongly, as a fatality. Focus on these cases with Doctissimo.


Pain and AIDS
More than a third of AIDS patients in pain. The causes of these sufferings are numerous. Thus, HIV infection itself can lead to pain, as well as drug and secondary opportunistic infections treatment that patients can develop AIDS .
Abdominal pain, oropharyngeal pain, headaches … Patients with AIDS are various pains. But whether acute or chronic pain is not inevitable. Many treatments (medicated or not) exist. It is therefore essential to establish a dialogue between the patient and the healthcare team. Indeed, only an accurate description of the patient experience will enable physicians to diagnose and develop a personalized treatment.

Pain and cancer
If at the beginning, the cancer is often silent disease, pain usually occur during the course of the disease. The primary cause of this pain is the tumor itself. Indeed, it sometimes irritates and alters its devices and as well as those of neighboring organs nerves. This nerve damage is then responsible for cancer pain. In addition, pain is sometimes secondary consequence of cancer treatment itself.

sensations The face of pain differ from one patient to another. This is why it is important not to minimize or silent suffering. Doctors know their mechanisms and are able to develop a suitable treatment for each, depending on the locality, the type and intensity of pain.

In the case of cancer or AIDS, physical and psychological pain affect the quality of life of the patient. However, there are many treatments tailored to each situation. That the disease has the least possible impact on the social life of the patient, it is essential to take care of the pain everyday. Only a dialogue with the medical team will implement solutions to improve the patient’s life.

Zona: when worries lurk

Generally very painful, herpes zoster is an acute dermatosis of viral origin. Opportunity to see how a small officer infection of four letters, benign in appearance, may our skin a real hell.

Most of us carry the herpes zoster virus. Origin: chicken pox! EH Yes, primary infection, this first contact, occurs during early childhood: varicella-zoster viruses do one.

worries lurk

Dr. Jekyll in childhood, Mister Hyde in adults
When chickenpox, the virus penetrates and multiplies in the airway and past in the blood then reaches the skin, its main target. There, it induces a characteristic vesicular rash in the form of small droplets. Once the rash is gone, the virus settles in sensory nerve ganglia (spinal posterior, cranial, dorsal roots) where it will remain permanently. Continue reading “Zona: when worries lurk”

Childbirth at home

Home birth is associated, in France as in most Western countries, with the images of the past, at the time where our grandmothers, not by choice but by necessity gave birth to their children in their bedroom. In some countries however, many deliveries take place yet at home. Return on this practice to the strains of nostalgia.

Proponents of the home birth, arguing the overmedicalization surrounding the birth, tirelessly cite the only and same country doing figure exception in Europe: the Netherlands.

chosen the right maternity

The Dutch example
If 30% of the Dutch give birth at home, it is important to remember that prevention policy is much greater than in France. And it is only if the pregnancy is safe, proposed a homebirth in a more familiar setting. Continue reading “Childbirth at home”

50 years of childbirth without pain

Created initially for the Steelworkers, the maternity ward of the Bluets in Paris has become the reference for painless childbirth. But since the 1950s, the preparation at birth has deeply changed. For Dr. Evelyne Petroff and Danielle Sfoggia today the accompaniment should be customized and fostering dialogue. They respond to issues of Doctissimo.

Doctissimo: Bluets surrogacy was pioneer in childbirth without pain. What developments experienced by this method?

Dr. Petroff and Sfoggia: Childbirth without pain has been developed by Dr. Fernand Lamaze and his team, after attending a birth in the former USSR. This method is based on two pillars. The first is pedagogical: it comes to learn the mother-to-be how birth, just as it would teach him to swim. Be given particular notions of anatomy. In the 1950s, pedagogy through lectures, and metallurgical workers ‘returning on the benches of the school”. The other pillar of the program is a physical component. It was based on the work of Pavlov at the time: it was of “deconditioning” women to suffer during childbirth. This happening by associate contraction with breathing to oxygenate baby, rather than associate it with pain.

childbirth without pain

This method was very controversial. In the 1970s, M. Leboyer added the concept of softness of the baby home. Light, gestures… the Leboyer method advocates a birth without violence. Then there was the arrival of the epidural in the 1980s, heavily dosed at the time. Women felt more nothing. They were passive, while Lamaze approach was intended to make them active. Need to find a balance between pain reduction and the involvement in its delivery.

Doctissimo: Precisely, how do you manage to find this balance?
Dr. Petroff and Sfoggia: Our goal is not to control the pain at all costs but to accompany women in what they wish to: singing, breathing, epidural dosed mini… We have women who opt for a method, and then change their mind along the way. Our support for the mother-to-be is refined. We are not aiming a kind “of ideal childbirth”, but what is best for each. But we keep the two pillars of the Lamaze, teaching method and physical approach. We give ourselves the means to propose more human accompaniments, favouring dialogue and Exchange. Thus, the educational part is done by classes diversified, with not more than 10 persons, from the 4e month of pregnancy. Because every woman is unique, and each baby is unique.

Doctissimo: But how do you manage to propose a personalised welcome, while most maternity wards are experiencing a real crisis?

Dr. Petroff and Sfoggia: First, it is true that we do not problem pregnancies. This allows us to concentrate on coaching. In addition, we work in network. Many doctors general practitioners and gynaecologists are related to our maternity to extend the monitoring. We regularly offer training.

Doctissimo: What is the profile of women who give birth at you and what methods of painless childbirth are preferred?
Dr. Petroff and Sfoggia: We give birth to 1,750 babies each year. But we do not have detailed data on the most methods. Because as I told you, many women change along the way. But in General, 70 to 80% of women are opting for a preparation for childbirth. Those who do not follow have often already practiced a technique they know. Or there may be other cultures, which will have specific approaches. With regard to the profile of expectant mothers, we welcome women of all backgrounds, of all socio-professional categories.

Doctissimo: Within your maternity, the father there a privileged position?
Dr. Petroff and Sfoggia: The father was always present during childbirth. But it is true that in the mid-1970s, there was a very militant movement so he attended the birth, cut the cord… Today, there is a return to more reason. Father occurs depending on what it is willing to do, there is no obligation. But there is a genuine work of the team, to make fathers feel welcomed as part of the adventure. They are welcome everywhere: in consultation, ultrasound, in preparation (“words of men” interview them is devoted), childbirth (even during caesarean sections) and in puerperium throughout the day.

Doctissimo: Under your auspices, a birth House will soon see the light of day?
Dr. Petroff and Sfoggia: This House of birth is expected in 2006. Attention, it is not an extension of motherhood the Bluets, but an autonomous structure, which will occur the liberal midwives. It will be attached to our maternity. The goal is to offer women a yet more custom tracking, and delivery “at home”. Because it is now almost impossible to give birth at home.

Who will give birth me?

It is with a tinted relief to apprehension that you see closer to the date of the birth. After having made acquaintance with doctors, midwives and even the anaesthetist, finally it is the encounter with your child. But in fact, who will be present the day?

Everything depends on the type of institution you have chosen, hospital or private clinic, and the nature of your pregnancy. Maternity wards are classified by levels. Pregnancies without complications are oriented towards a level 1. Then there are 2 levels that include a neonatal unit to which address example twin pregnancies. Finally, level 3 have a Neonatal ICU. Anyway, from 1,500 births a year, regulation requires 24 hours of a full medical team (pediatrician, gynecologist-obstetrician, anaesthetist, midwives, etc).

Who will give birth me

In the structures of first, or even second-level operation of the team differs. The midwife and obstetrician doctor are custody, i.e. present on the spot, while anaesthetist or pediatrician doctors are on call, in other words physically absent, but can be “Mexican”. Finally in the private structures, you’ll case the midwife, physician accoucheur not moving during the last phase of the work, for the release of the baby. Continue reading “Who will give birth me?”

Diabetes, know the symptoms and risk factors

Diabetes is a metabolic disorder characterized by an excess of sugar in the blood. In France, more than three million people are supported for this disease, or 4.6% of the population. While their number is constantly increasing (+ 5.4% per year between 2000 and 2011), a diabetic on six would not be diagnosed.

The most common diabetes is type 2 diabetes which affects 90% of diabetics and usually occurs in overweight more than 50 years. Conversely, the type 1 diabetes appears rather in children, in whom it causes weight loss. Pr Jean-Fran├žois Gautier, endocrinologist-diabetologist, precise symptoms and risk factors related to each of these two types.

Risk Factors Diabetes

Type 1 or type 2, diabetes is an excess of sugar in the blood
Diabetes is related to insufficient or improper use ofinsulin, a hormone that helps glucose (sugar) to enter the cells. That it remains so in the blood in excessive amounts, it is hyperglycemia. In France, more than three million people are treated for diabetes. Continue reading “Diabetes, know the symptoms and risk factors”

Keratitis, ulcer, abscess of cornea

The cornea, this fine transparent membrane covering the pupil and iris, is fragile. His injuries, whether they are superficial (keratitis) or more deep (ulcers), pose an infectious risk (corneal abscess) or poor healing, engaging Visual prognosis.

Related to the projection of liquid or solid particles in the eye, favored by dry eye and contact lenses, the keratitis, ulcers and corneal abscess are extremely common and can occur at any age. The Pr Christophe Baudouin *, ophthalmologist, returns on the warning signs and taking care of these pathologies.

abscess of cornea

A red and painful eye sign the ulcer of the cornea
Corneal ulcer, also called ulcerative keratitis, is an infringement of the surface of the eye, at the level of the essential vision transparent layers. It is an intermediate injury between the relatively superficial keratitis and corneal perforation. If there is infection, one speaks of abscess of cornea. Continue reading “Keratitis, ulcer, abscess of cornea”

Facilitate access by minors to contraception

While 18,000 young girls became pregnant in 2010, only 4,500 have gone at the end of their pregnancy. To avoid unintended pregnancies, a report is to be delivered to the Secretary of State for youth stressing the need for anonymous and free contraception for all teenage minor.

Being pregnant at 13 or 14 years, this is not normal. If certain songs, movies and TV shows sometimes evoke teenage pregnancies with idealism, the reality is often difficult for very young mothers suffered some insecurity. The subject of teenage pregnancies and abortion, behind is before all a lack of information and access to adequate contraception.


The paradox of contraception
In their report on the contraception and abortion of girls, Professor Israel Nisand, Dr. Brigitte Letombe (gynecologists) and Sophie Marinopoulos (psychologist), highlight a paradox that is specific to the France. Abortion and emergency contraception are free, anonymous, while contraception is paid or refundable by the social security of parents, thus requiring their authorization. “In France, we prefer to pay abortion rather than contraception” exclaims the Israel Nisand gynecologist.

Today, the contraceptive pill is given free of charge in family planning, which respect the anonymity and confidentiality of patients. However, they are rare in rural areas and the family planning association deplored the lack of means and calls to sign a petition for “Defend the right to information and education in sexuality”.

Package contraception for minors
The 18 proposals in the report, include provision of anonymously and free of contraception all and up to age 18 (and condoms under conditions of resources of 18 to 25 years). This proposal could emerge in the form of a “contraception for minor package” proposed by the State voluntary pharmaceutical laboratories. “Annual cost by minor would be around 80 euros in addition to the price of an annual consultation of renewal”, assess the authors. A cost to “put next to the cost of an abortion (on the order of 350 euros) which takes into account costs occasioned by suspicion of pregnancy, or emergency contraception, nor psychological consequences of Abortions to minors, if difficult to measure”, continuing the specialists.

The idea is also to provide suitable contraceptives minor. “We always speak of the pill, but most of the time, it is not suitable for the girls; It is better to provide the patch, the ring , or the implant, who avoid accidents. Unfortunately, these new methods of contraception are not reimbursed to date”adds Jeannette Bougrab, Secretary of State for youth.

Inform… from kindergarten!
Avoid unwanted pregnancies, it also passes by informing adolescents about sexuality and its consequences. According to the Nissan Professor, “pornography educates our children. Near three boys on four and more than a girl on two began to consume pornography before the age of 14 years”. In addition to maintaining the law of 2001 on school-based sexuality information, the report suggests to provide information on “la vie affective, emotional, sentimental” and respect for oneself in a sexed body report from kindergarten for the dialogue to become fluid and constant on these subjects, from the earliest age. How to apply to adolescents, specialists exclaim in echo ‘stop at the pure information only. “Young people need information but also especially to feel listened, to speak freely”.

But facing the sexuality of adolescents are also parents need help. They may indeed find it difficult to interact with their children. The report suggested the creation of places of parent-child home offering a listen for anonymous and free.