Prise en charge des cancers des voies aéro-digestives supérieures chez les patients de plus de 75 ans (à propos de 59 cas et revue de la littérature)

ANGERS-BU Médecine-Pharmacie (490072105) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Traitement du cholestéatome de l'oreille moyenne: Résultats fonctionnels sur une série de 191 patients.

ANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF

Santé communautaire pour les personnes âgées: l'activité de la policlinique de gériatrie à Genève

Outre son activité clinique principalement domiciliaire, la Policlinique de gériatrie a choisi de développer trois programmes d'activité spécifiques ayant pour objectifs communs la promotion de la santé et le maintien à domicile, dans les meilleures conditions, aussi longtemps que désiré. Cet article décrit ces programmes.In addition to its mainly home-based clinical activity, the Geriatric Policlinic has chosen to develop three programmes with a specific activity. Their common objectives being promoting health and maintaining home-based treatment in the best conditions and for as long as possible. This article describes these programmes

Bilateral hypoglossal nerve stimulation for treatment of adult obstructive sleep apnoea

Background and aim Hypoglossal nerve stimulation (HNS) decreases obstructive sleep apnoea (OSA) severity via genioglossus muscle activation and decreased upper airway collapsibility. This study assessed the safety and effectiveness at 6 months post-implantation of a novel device delivering bilateral HNS via a small implanted electrode activated by a unit worn externally, to treat OSA: the Genio™ system. Methods This prospective, open-label, non-randomised, single-arm treatment study was conducted at eight centres in three countries (Australia, France and the UK). Primary outcomes were incidence of device-related serious adverse events and change in the apnoea–hypopnoea index (AHI). The secondary outcome was the change in the 4% oxygen desaturation index (ODI). Additional outcomes included measures of sleepiness, quality of life, snoring and device use. This trial was registered with ClinicalTrials.gov, number NCT03048604. Results 22 out of 27 implanted participants (63% male, aged 55.9±12.0 years, body mass index (BMI) 27.4±3.0 kg·m−2) completed the protocol. At 6 months BMI was unchanged (p=0.85); AHI decreased from 23.7±12.2 to 12.9±10.1 events·h−1, a mean change of 10.8 events·h−1 (p\u3c0.001); and ODI decreased from 19.1±11.2 to 9.8±6.9 events·h−1, a mean change of 9.3 events·h−1 (p\u3c0.001). Daytime sleepiness (Epworth Sleepiness Scale; p=0.01) and sleep-related quality of life (Functional Outcomes of Sleep Questionnaire-10; p=0.02) both improved significantly. The number of bed partners reporting loud, very intense snoring, or leaving the bedroom due to participant snoring decreased from 96% to 35%. 91% of participants reported device use \u3e5 days per week, and 77% reported use for \u3e5 h per night. No device-related serious adverse events occurred during the 6-month post-implantation period. Conclusions Bilateral HNS using the Genio™ system reduces OSA severity and improves quality of life without device-related complications. The results are comparable with previously published HNS systems despite minimal implanted components and a simple stimulation algorithm