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La Revue du praticien最新文献

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[Pain mechanisms involved in chronic pelvi-perineal pain]. 慢性盆腔会阴疼痛的疼痛机制。
La Revue du praticien Pub Date : 2025-04-01
Marguerite D'Ussel
{"title":"[Pain mechanisms involved in chronic pelvi-perineal pain].","authors":"Marguerite D'Ussel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>PAIN MECHANISMS INVOLVED IN CHRONIC PELVI-PERINEAL PAIN. Chronic pelvic and perineal pain, like other chronic pain, often is the result of specific organic lesion mechanisms, but can lead, via central and peripheral sensitization mechanisms, to dysfunctions that maintain the pain autonomously. To manage this type of pain in the most appropriate way, it is necessary to understand the mechanisms involved, and therefore the anatomical basis of the region, the neurophysiology of \"normal\" pain, and finally the various components involved when pain becomes chronic. The latter can become therapeutic levers.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"386-388"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Choosing suitable dressing]. [选择合适的调味品]。
La Revue du praticien Pub Date : 2025-04-01
Axelle Moreau, Ulrique Michon-Pasturel
{"title":"[Choosing suitable dressing].","authors":"Axelle Moreau, Ulrique Michon-Pasturel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>CHOOSING SUITABLE DRESSING. The management of a wound can range from simple and quick to extremely complicated depending on whether it is an acute post-traumatic wound occurring on healthy skin or a chronic wound of vascular origin for example. In this treatment, knowledge of dressings is useful as a tool to aid healing but does not exempt us from understanding the mechanisms causing this wound. In the case of chronic wounds, those that have been in progress for more than four weeks, an etiological investigation is essential, including a peripheral arterial vascular and venolymphatic system evaluation. Once the cause has been identified, dressings contribute to healing but are not the only factors making it possible. Comprehensive care is necessary, considering the patient's lifestyle, their nutritional status, their compliance with treatment, and the use of dressings including compression. There is no suitable dressing common to all situations. Some dressings have properties that allow them to be applied at several stages of healing. The care protocols are therefore evolving, depending on the appearance of the wound.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"355-362"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Pelvic-perineal muscle pain syndromes]. [盆腔-会阴肌肉疼痛综合征]。
La Revue du praticien Pub Date : 2025-04-01
Véronique Bonniaud
{"title":"[Pelvic-perineal muscle pain syndromes].","authors":"Véronique Bonniaud","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>PELVIC-PERINEAL MUSCLE PAIN SYNDROMES. The search for muscle pain in the lower abdominal, gluteal and perineal regions is part of the systematic clinical examination of all pelvic perineal pain. These points of muscle hypersensitivity are very frequent, can be accompanied by pain projected in the territories of nerves of thoraco-lumbar and/or sacred origin. The interrogation and a careful clinical examination allow the diagnosis of projected pain, in the syndrome of the thoracolumbar hinge and in the myofascial syndromes of the pelvitrochanterian muscles, psoas and levator ani. The finding of a muscle component during chronic pelviperineal pain must have therapeutic consequences. Physiotherapy is part of a multidisciplinary therapeutic strategy for chronic pain.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"420-424"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Tibola syndrome]. (Tibola综合症)。
La Revue du praticien Pub Date : 2025-04-01
Mathieu Diallo, Claudine Lyps
{"title":"[Tibola syndrome].","authors":"Mathieu Diallo, Claudine Lyps","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"435"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Irritable bowel syndrome]. [肠易激综合症]。
La Revue du praticien Pub Date : 2025-04-01
Jean-Marc Sabaté
{"title":"[Irritable bowel syndrome].","authors":"Jean-Marc Sabaté","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>IRRITABLE BOWEL SYNDROME. Irritable bowel syndrome (IBS) is a common functional digestive disorder affecting 4 to 10% of the population, with a female gender predominance. Although it is a benign disease, it can sometimes considerably impair quality of life particularly in severe cases. Diagnosis should be clinical based on symptoms, with limited complementary examinations for the sole purpose of differential diagnosis elimination. A better understanding of IBS mechanisms has led to the development of various therapeutic strategies. Antispasmodics and transit modifiers are the most commonly strategies used. Dietary management with diets, probiotics, physical activity, alternative treatments such as hypnosis and therapeutic education can also improve IBS symptoms and reduce severity.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"408-413"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Vulvodynias].
La Revue du praticien Pub Date : 2025-04-01
Éric Bautrant
{"title":"[Vulvodynias].","authors":"Éric Bautrant","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>VULVODYNIAS. Vulvodynia is a chronic pain. The distinction between so-called \"provoked\" vulvodynia and \"spontaneous\" vulvodynia allows a diagnostic and therapeutic orientation. \"Provoked\" vulvodynia responds to the mechanisms of hyperalgesia encountered in hypersensitization. The model is provoked vestibulodynia. The model of \"spontaneous\" vulvodynia is pudendal nerve neuralgia, whose mechanism is neuropathic pain. Other types of vulvodynia are due to peripheral sensitization or integrated into the central pelvic hypersensitization syndrome and the vulvodynia of myofascial syndromes and the clitorodynia. Finally, a specific place will be given to the persistent genital arousal disorder (PGAD). Understanding vulvodynia requires a good knowledge of the anatomy and the mechanisms of peripheral and central sensitization.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"414-419"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Prevention and monitoring of pertussis]. [百日咳的预防和监测]。
La Revue du praticien Pub Date : 2025-04-01
Nicole Guiso, Jacques Gaillat
{"title":"[Prevention and monitoring of pertussis].","authors":"Nicole Guiso, Jacques Gaillat","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"457"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Chronic coccygodynia].
La Revue du praticien Pub Date : 2025-04-01
Thibault Riant, Cristina Graur
{"title":"[Chronic coccygodynia].","authors":"Thibault Riant, Cristina Graur","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>CHRONIC COCCYGODYNIA. Chronic coccygodynia is defined as pain in the c occyx which has been present for more than six months and which is aggravated by sitting down and/or rising. Although the diagnosis is primarily clinical, additional imaging examinations (MRI, even scintigraphy) are necessary to look for symptomatic forms of curable pathologies such as tumors in the region. These investigations can also help to elucidate the pathophysiological mechanisms responsible for the pain. Dynamic X-rays (sitting and standing) of the coccyx remain the reference exam. Coccygeal ultrasound with a dynamic maneuver (digital intrarectal mobilization of the coccyx) represents an innovative alternative that has not yet been fully validated. The most frequent causes are hypermobile or rigid coccyxes and coccygeal spicules. Traumatic or post-obstetric causes are often found. The social and painful consequences are such as justifying recourse to treatment. Firstly, manual therapies, then infiltrations and possibly the use of topicals, and finally surgery for the most intractable cases.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"405-407"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[From vaccination to smallpox eradication]. [从接种疫苗到根除天花]。
La Revue du praticien Pub Date : 2025-04-01
Patrick Berche
{"title":"[From vaccination to smallpox eradication].","authors":"Patrick Berche","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"459-462"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Pudendal neuralgias].
La Revue du praticien Pub Date : 2025-04-01
Éric Bautrant
{"title":"[Pudendal neuralgias].","authors":"Éric Bautrant","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>PUDENDAL NEURALGIAS. Diagnosis of pudendal neuralgia (NP) is clinical, based on the neuropathic type of pain and its topography, in the territory of the terminal branches of the pudendal nerve. It does not require specific paraclinical exploration and perineal electromyography should no longer be systematically proposed. However, a pelvic exploration such as magnetic resonance imaging (MRI) should be requested to rule out any tumoral pathology or anatomical anomaly. The most well-known cause is pudendal nerve entrapment (PNE). This syndrome must meet the five Nantes criteria and include a clear response to local anesthetics injection. Among other causes, known as \"non-entrapped\" neuropathies, we can mention: stretching neuropathies from dystocic deliveries, direct traumatic neuropathies, metabolic neuropathies of diabetes, herpes infections, chemotherapy-induced neuropathies, toxic neuropathies, and encountered in myofascial syndromes of the buttock or perineal muscles. It is also important to recognize the neuropathic pudendal pain, often poorly systematized and associated with other pelvic pains, from central pelvic hypersensitization. The treatment of PNE benefits from management recommendations (Convergences PP), including a first-line multimodal treatment. In case of failure and after a positive response to the block test, decompression-neurolysis surgery should be considered due to its low aggressiveness, its effectiveness in pain improvement (70 to 80%), and its healing rate (50 to 60%) in properly selected patients. Radiofrequency and cryotherapy, as well as botulinum toxin injections, do not have sufficient evidence and can only be proposed as third-line treatments, within therapeutic protocols, in specialized centers. Neuromodulation and the peri-nerve catheter, connected to a continuous diffusion pump of local anesthetics, are considered in case of failure or recurrence after surgery.</p>","PeriodicalId":94123,"journal":{"name":"La Revue du praticien","volume":"75 4","pages":"392-396"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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