La Revue du praticien
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La Revue du praticien · Feb 2007
Review Case Reports[Lesions of ligaments and menisci of the knee and the ankle].
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La Revue du praticien · Feb 2007
Review Comparative Study[Management of localized germ-cell tumours of the testis].
Stage 1 is currently the most frequent pattern at diagnosis of germ-cell tumours. Prognosis is excellent and different options are available after orchidectomy. ⋯ In case of pure seminoma, prophylactic radiotherapy directed to the retroperitoneal lymph nodes, chemotherapy by single-agent carboplatin and surveillance with differed treatment at relapse are the three currently available attitudes. In non-seminomatous germ cell tumours three options should also be considered: surveillance (watchful waiting), chemotherapy by two cycles of BEP, or retroperitoneal lymph node dissection.
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The postdural puncture headache is a frequent iatrogenic complication due to an excessive leakage of cerebrospinal fluid. The leak through the dural perforation mainly depends on the size and design of the needle. ⋯ Symptoms resolve spontaneously within 1 week or within 48 hours after autologous epidural blood patch. Prevention is based on using small-gauge pencil-point needles whereas the duration of bed rest has no effect on the incidence of postlumbar puncture headache.
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La Revue du praticien · Feb 2007
Review Comparative Study Historical Article[Treatment of cancer: surgery, radiotherapy, chemotherapy, hormonal therapy. Multidisciplinary therapeutic decision making and informing the patient].
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Organ transplantation, the gold standard therapy for end-stage organ failures, has become a victim of its success. Indeed, the number of patients listed for transplantation has been increasing faster than that of available grafts. The number of brain-dead donors, the primary source of organ donation in France, is limited, but this figure is becoming more and more comprehensive, thanks to the work carried out by hospital transplant coordination units. ⋯ Each donor source is associated with different constraints and limitations in terms of available resources, removal organization and ethics. For cadaver donors, the key ethical issues are the acceptance of presumed consent, the difficulty in diagnosing the exact time of death and the notion of body integrity. For living donors, the ethical issues are related to the quality of the consent and the assessment of the risk undertaken by the donor, when no personal benefit is expected.