Hôpital de la Roche-Guyon

Background: Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease frequently associated with atopic conditions in children. However, the extent and nature of this association remain unclear. We retrospectively estimated the pr

Polyhandicap is characterized by a combination of profound intellectual disability and serious motor deficit, resulting in the extreme restriction of autonomy and communication. The aim of the EVAL-PLH (EVALuation PoLyHandicap) study is to identify the impact of socioeconomic, environmental, and epidemiological determinants on the health status of the persons with polyhandicap and the daily lives of their caregivers. EVAL-PLH is a prospective cohort study. The study involved persons with severe polyhandicap (who were cared for at reeducation centers, residential facilities, and one specialized pediatric/neurological department of a university hospital), their familial caregivers and the institutional caregivers. Data collection included sociodemographics, heath status, and psychocomportemental information. Data have been collected at 2 points (2015-2016 and 2020-2021). The French EVAL-PLH cohort is the first cohort study focusing on persons with polyhandicap, their families, and the health care workers caring for them. The sustainability of the device is essential to assist patients, families, clinicians, and health decision-making authorities in the optimization of care management.

L'evaluation de la douleur chez le sujet severement polyhandicape est particulierement difficile du fait de la restriction extreme de l'autonomie, des possibilites de perception, d'expression et de relation qui definissent cette pathologie. Nous avons elabore et valide une echelle d'heteroevaluation comportant 10 ITEMS adaptee a ce type de patient. Nous rapportons nos premieres experiences d'utilisation de cette grille sur 25 dossiers tires au sort. Pour apprecier l'impact potentiel de l'utilisation de l'echelle, nous mettons en parallele chaque situation clinique et la decision proposee par l'echelle. L'echelle d'evaluation permet une meilleure sensibilite dans l'approche diagnostique de la douleur puisqu'elle propose une decision binaire avec la necessite de reconsiderer le traitement antalgique dans des situations ou le clinicien ne prend pas spontanement cette option.