Julien Nizard - Academia.edu (original) (raw)

Papers by Julien Nizard

Douleur Et Analgesie, Mar 1, 2016

L'hypervigilance, la focalisation, l'évitement font partie du vocabulaire utilisé par le clinicie... more L'hypervigilance, la focalisation, l'évitement font partie du vocabulaire utilisé par le clinicien qui s'occupe de la douleur chronique. Ces notions renvoient à des processus bien connus en psychologie cognitive et correspondent au fonctionnement et au dysfonctionnement de l'attention sélective. L'objectif de cet article est de s'intéresser à ces processus attentionnels impliqués dans la douleur chronique en s'attachant à préciser leur nature (de quelle composante attentionnelle s'agit-il ?), les différents paradigmes expérimentaux permettant de les évaluer (méthode, résultat et interprétation) et enfin en discutant de leurs principales implications (cliniques et thérapeutiques).

Douleur Et Analgesie, Sep 1, 2003

Douleur Et Analgesie, Jul 31, 2015

RésuméIntroductionL’étude avait pour objectif d’évaluer l’efficacité de la stimulation sous-cutan... more RésuméIntroductionL’étude avait pour objectif d’évaluer l’efficacité de la stimulation sous-cutanée (SSC) dans le cadre de lombalgies réfractaires à composante neuropathique.Patients et méthodesL’étude a porté sur 11 patients. Les critères de jugement cliniques étaient l’intensité douloureuse (EN), le pourcentage d’amélioration globale, la satisfaction du patient, le périmètre de marche et le score de consommation médicamenteuse (MQS).RésultatsSoixante-douze pour cent des patients ont été satisfaits avec une diminution significative de la douleur:–5,2 (± 1,3) sur l’EN, une amélioration estimée à 75 % et un MQS en baisse de 45 %. La durée moyenne de suivi a été de 11 mois.ConclusionLa SSC lombaire a amélioré de façon significative les 11 patients de cette étude, avec un soulagement durable à moyen et long termes.AbstractAimThe aim of the study was to evaluate the efficacy of the subcutaneous nerve stimulation (SNS) for the treatment of intractable chronic low back pain with neuropathic components.Patients and methodsEleven patients were studied. Clinical end points were: severity of pain (NRS), percentage improvement of pain, patient satisfaction with treatment, walking distance (QS), and medication consumption (MQS).Results1) The mean duration of follow-up was 11 months. 2) Seventy-two percent of patients were satisfied and obtained a significant improvement of pain of 5.2 (± 1.3) points on the NRS, a percentage improvement of 75% (± 16.3) and an MQS decrease of 45%.ConclusionThe SNS significantly improved the 11 patients of this study with sometimes complete and lasting mediumand long-term relief.

Douleurs : Evaluation - Diagnostic - Traitement, Jun 1, 2019

Revue du Rhumatisme, Nov 1, 2016

Communications posters électroniques / Revue du Rhumatisme 83S (2016) A163-A304 A166 aussi l'impa... more Communications posters électroniques / Revue du Rhumatisme 83S (2016) A163-A304 A166 aussi l'impact psycho-social et sociétal du RP. L'ICF est une approche utile pour la classification systématique de l'impact de la maladie. Conflit d'intérêt.-aucun Références bibliographiques [1]

Journal De Gynecologie Obstetrique Et Biologie De La Reproduction, 2006

Journal de Gynecologie Obstetrique et Biologie de la Reproduction - Vol. 35 - N° 1 - p. 87-88

Santé publique, 2002

Les systèmes de santé français et anglais : évolution comparée depuis le milieu des années 90

Neurophysiologie Clinique-clinical Neurophysiology, Feb 1, 2017

OBJECTIVE To assess the efficacy of a combination of cognitive training (COG) and repetitive tran... more OBJECTIVE To assess the efficacy of a combination of cognitive training (COG) and repetitive transcranial magnetic stimulation (rTMS), on cognitive performance, locomotor activity, apathy, caregiver burden and dependence of patients with Alzheimer's disease (AD). METHODS A combination of COG and rTMS was performed in 10 patients with AD (NeuroAD procedure) for a period of 5weeks (one session per day, 5days a week), without maintenance sessions. Patients were evaluated at the end of the treatment (D45) and 6months later (M6) by the Mini Mental State Examination (MMSE), the Alzheimer disease assessment scale - cognitive subscale (ADAS-Cog), various neuropsychological tests and clinical scores specific for locomotor activity, apathy, caregiver burden, and dependence, recorded before the study (baseline). RESULTS The primary endpoint was the improvement of the ADAS-Cog score at D45, which was reached. Six months after the end of the treatment, the ADAS-Cog score returned to baseline value, except for the best responders who remained significantly improved. The other main result was the improvement of apathy and dependence scores at both D45 and M6 for the entire series of patients. No serious adverse events occurred and all patients completed the study. CONCLUSIONS The results of this open-label study confirm the feasibility of the rTMS-COG procedure in AD patients, and suggest that these patients can benefit from the procedure, in terms of cognitive performances, apathy and dependence, even in the long term. These promising results remain to be confirmed in controlled studies based on a larger population size, which could also help identify the prognostic factors associated with good outcome, in order to optimize patient selection.

Journal of Clinical Medicine, May 10, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 2006

Douleurs : Evaluation - Diagnostic - Traitement, Nov 1, 2012

European Journal of Pain, Sep 19, 2022

ObjectiveTo conduct a systematic review to identify which tools are being used to assess body per... more ObjectiveTo conduct a systematic review to identify which tools are being used to assess body perception disturbances in Complex Regional Pain Syndrome (CRPS) and to provide an evidence‐based recommendation in the selection of an assessment tool, based on measurement properties.Databases and data treatmentFive electronic databases (EMBASE, Pubmed, PsycInfo, Science Direct and Web of Science) were searched for English or French written articles, with no time restrictions. All original articles using a body perception assessment tool with adult patients with CRPS were selected, regardless of their design (controlled trials, single case, qualitative study). Two investigators screened abstracts, selected full articles and extracted data independently.ResultsThirty‐eight full‐text papers were obtained and three main methods to evaluate body perception disturbances were identified: The Bath Body Perception Disturbance Scale, the Neglect‐like Symptoms questionnaire adapted from Galer and the patient's body perception description. No full psychometric assessments were found. The Limb Laterality Recognition Task was also used in conjunction with another method.ConclusionsThree main assessment methods for CRPS body perception disturbances are currently used. Full psychometric evaluation has not been completed for any of the assessment methods. As a consequence, we could not fully apply the COSMIN guideline. To date, there is no agreement concerning the use of a specific questionnaire or scale. The results indicate a need for further research such as psychometric properties of these questionnaires.SignificanceThis systematic review identified body perception disturbances assessment methods and their the psychometric properties in order to provide help and guidance to researchers and clinicians to investigate those clinical features.

BMC Palliative Care, Feb 28, 2023

Background Pain is a common symptom in palliative care cancer patients and is often insufficientl... more Background Pain is a common symptom in palliative care cancer patients and is often insufficiently relieved. In recent years, transcranial direct-current stimulation (tDCS) of the motor cortex has been shown to be effective to treat chronic pain, essentially neuropathic pain. We propose to test the efficacy of tDCS in patients experiencing cancer pain in the palliative care setting. Method/design This article describes the protocol of a bicentre, randomized, parallel-arm, sham-controlled clinical trial evaluating tDCS in the treatment of palliative care patients with refractory cancer pain. Seventy patients between the ages of 18 and 80 years experiencing refractory pain with a pain score of 4/10 on a numerical rating scale (NRS) ranging from 0 to 10 will be enrolled in this trial. The main exclusion criteria are patients unable to fill in the various rating scales and life expectancy less than 3 weeks. Treatment consists of 5 consecutive tDCS sessions targeting the motor cortex (one daily session for 5 days) on the contralateral side to the pain. After randomization (1:1 ratio), 35 patients will receive active stimulation and 35 patients will receive sham stimulation. The primary endpoint is the NRS score and the primary objective is a significant improvement of this score between the baseline score recorded between D-3 and D-1 and the score recorded 4 days after stopping treatment (D8). The secondary objectives are to evaluate whether this improvement is maintained 16 days after stopping treatment (D21) and whether the following scores are improved on D14 and D21: Brief Pain Inventory, Edmonton Symptom Assessment System, Hospital Anxiety and Depression scale, State-Trait Anxiety Inventory and Medication Quantification Scale. Discussion Positive results of this trial would indicate that tDCS can improve pain and quality of life of cancer patients in the palliative care setting. Reduction of analgesic consumption and improvement of activities of daily living should allow many patients to return home with a decreased workload for caregivers.

Douleur Et Analgesie, Sep 1, 2003

la participation à son équipe d'un médecin-conseil. Le praticien, en poste dans l'établissement, ... more la participation à son équipe d'un médecin-conseil. Le praticien, en poste dans l'établissement, est naturellement devenu le parte-naire spécifique de cette activité. Il y trouve un grand intérêt. Le désir d'explication des positions adoptées par l'assurance maladie, le rôle d'interface entre les univers du soin et de la protection sociale prennent tout leur sens dans une fonction d'accompagnement de la structure hospitalière mais aussi des malades. Il participe régulièrement aux staffs de l'équipe pluridisciplinaire, rencontre, à la demande, les patients qui souhaitent un dialogue avec lui et rend compte de son point de vue au responsable du centre, mais aussi souvent, avec l'accord du patient, au médecin conseil du patient.

Joint Bone Spine, May 1, 2023

BMJ Supportive & Palliative Care

ObjectivesLimited descriptive data are available on continuous and deep sedation maintained until... more ObjectivesLimited descriptive data are available on continuous and deep sedation maintained until death (CDSUD) at the patient’s request in palliative care units. This study aimed to describe such practices in the context of refractory suffering or after a request to stop life-sustaining treatment, evaluating the duration and dosage of sedative treatments used.MethodsThis retrospective observational study included consecutively hospitalised patients in a palliative care unit from January 2020 to December 2021. Data on patient profiles, reasons for the sedation request, duration of sedation and doses of sedatives were collected.ResultsAmong 42 patients who underwent CDSUD, 79% occurred due to refractory suffering. In cases of sedation following a request to stop life support, high-dose corticosteroid therapy was the most commonly involved life-sustaining treatment. Midazolam was always the first-line sedative treatment. Chlorpromazine was added in 79% of cases, and propofol in 40%, t...

Douleur Et Analgesie, Mar 1, 2016

L'hypervigilance, la focalisation, l'évitement font partie du vocabulaire utilisé par le clinicie... more L'hypervigilance, la focalisation, l'évitement font partie du vocabulaire utilisé par le clinicien qui s'occupe de la douleur chronique. Ces notions renvoient à des processus bien connus en psychologie cognitive et correspondent au fonctionnement et au dysfonctionnement de l'attention sélective. L'objectif de cet article est de s'intéresser à ces processus attentionnels impliqués dans la douleur chronique en s'attachant à préciser leur nature (de quelle composante attentionnelle s'agit-il ?), les différents paradigmes expérimentaux permettant de les évaluer (méthode, résultat et interprétation) et enfin en discutant de leurs principales implications (cliniques et thérapeutiques).

Douleur Et Analgesie, Sep 1, 2003

Douleur Et Analgesie, Jul 31, 2015

RésuméIntroductionL’étude avait pour objectif d’évaluer l’efficacité de la stimulation sous-cutan... more RésuméIntroductionL’étude avait pour objectif d’évaluer l’efficacité de la stimulation sous-cutanée (SSC) dans le cadre de lombalgies réfractaires à composante neuropathique.Patients et méthodesL’étude a porté sur 11 patients. Les critères de jugement cliniques étaient l’intensité douloureuse (EN), le pourcentage d’amélioration globale, la satisfaction du patient, le périmètre de marche et le score de consommation médicamenteuse (MQS).RésultatsSoixante-douze pour cent des patients ont été satisfaits avec une diminution significative de la douleur:–5,2 (± 1,3) sur l’EN, une amélioration estimée à 75 % et un MQS en baisse de 45 %. La durée moyenne de suivi a été de 11 mois.ConclusionLa SSC lombaire a amélioré de façon significative les 11 patients de cette étude, avec un soulagement durable à moyen et long termes.AbstractAimThe aim of the study was to evaluate the efficacy of the subcutaneous nerve stimulation (SNS) for the treatment of intractable chronic low back pain with neuropathic components.Patients and methodsEleven patients were studied. Clinical end points were: severity of pain (NRS), percentage improvement of pain, patient satisfaction with treatment, walking distance (QS), and medication consumption (MQS).Results1) The mean duration of follow-up was 11 months. 2) Seventy-two percent of patients were satisfied and obtained a significant improvement of pain of 5.2 (± 1.3) points on the NRS, a percentage improvement of 75% (± 16.3) and an MQS decrease of 45%.ConclusionThe SNS significantly improved the 11 patients of this study with sometimes complete and lasting mediumand long-term relief.

Douleurs : Evaluation - Diagnostic - Traitement, Jun 1, 2019

Revue du Rhumatisme, Nov 1, 2016

Communications posters électroniques / Revue du Rhumatisme 83S (2016) A163-A304 A166 aussi l'impa... more Communications posters électroniques / Revue du Rhumatisme 83S (2016) A163-A304 A166 aussi l'impact psycho-social et sociétal du RP. L'ICF est une approche utile pour la classification systématique de l'impact de la maladie. Conflit d'intérêt.-aucun Références bibliographiques [1]

Journal De Gynecologie Obstetrique Et Biologie De La Reproduction, 2006

Journal de Gynecologie Obstetrique et Biologie de la Reproduction - Vol. 35 - N° 1 - p. 87-88

Santé publique, 2002

Les systèmes de santé français et anglais : évolution comparée depuis le milieu des années 90

Neurophysiologie Clinique-clinical Neurophysiology, Feb 1, 2017

OBJECTIVE To assess the efficacy of a combination of cognitive training (COG) and repetitive tran... more OBJECTIVE To assess the efficacy of a combination of cognitive training (COG) and repetitive transcranial magnetic stimulation (rTMS), on cognitive performance, locomotor activity, apathy, caregiver burden and dependence of patients with Alzheimer's disease (AD). METHODS A combination of COG and rTMS was performed in 10 patients with AD (NeuroAD procedure) for a period of 5weeks (one session per day, 5days a week), without maintenance sessions. Patients were evaluated at the end of the treatment (D45) and 6months later (M6) by the Mini Mental State Examination (MMSE), the Alzheimer disease assessment scale - cognitive subscale (ADAS-Cog), various neuropsychological tests and clinical scores specific for locomotor activity, apathy, caregiver burden, and dependence, recorded before the study (baseline). RESULTS The primary endpoint was the improvement of the ADAS-Cog score at D45, which was reached. Six months after the end of the treatment, the ADAS-Cog score returned to baseline value, except for the best responders who remained significantly improved. The other main result was the improvement of apathy and dependence scores at both D45 and M6 for the entire series of patients. No serious adverse events occurred and all patients completed the study. CONCLUSIONS The results of this open-label study confirm the feasibility of the rTMS-COG procedure in AD patients, and suggest that these patients can benefit from the procedure, in terms of cognitive performances, apathy and dependence, even in the long term. These promising results remain to be confirmed in controlled studies based on a larger population size, which could also help identify the prognostic factors associated with good outcome, in order to optimize patient selection.

Journal of Clinical Medicine, May 10, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 2006

Douleurs : Evaluation - Diagnostic - Traitement, Nov 1, 2012

European Journal of Pain, Sep 19, 2022

ObjectiveTo conduct a systematic review to identify which tools are being used to assess body per... more ObjectiveTo conduct a systematic review to identify which tools are being used to assess body perception disturbances in Complex Regional Pain Syndrome (CRPS) and to provide an evidence‐based recommendation in the selection of an assessment tool, based on measurement properties.Databases and data treatmentFive electronic databases (EMBASE, Pubmed, PsycInfo, Science Direct and Web of Science) were searched for English or French written articles, with no time restrictions. All original articles using a body perception assessment tool with adult patients with CRPS were selected, regardless of their design (controlled trials, single case, qualitative study). Two investigators screened abstracts, selected full articles and extracted data independently.ResultsThirty‐eight full‐text papers were obtained and three main methods to evaluate body perception disturbances were identified: The Bath Body Perception Disturbance Scale, the Neglect‐like Symptoms questionnaire adapted from Galer and the patient's body perception description. No full psychometric assessments were found. The Limb Laterality Recognition Task was also used in conjunction with another method.ConclusionsThree main assessment methods for CRPS body perception disturbances are currently used. Full psychometric evaluation has not been completed for any of the assessment methods. As a consequence, we could not fully apply the COSMIN guideline. To date, there is no agreement concerning the use of a specific questionnaire or scale. The results indicate a need for further research such as psychometric properties of these questionnaires.SignificanceThis systematic review identified body perception disturbances assessment methods and their the psychometric properties in order to provide help and guidance to researchers and clinicians to investigate those clinical features.

BMC Palliative Care, Feb 28, 2023

Background Pain is a common symptom in palliative care cancer patients and is often insufficientl... more Background Pain is a common symptom in palliative care cancer patients and is often insufficiently relieved. In recent years, transcranial direct-current stimulation (tDCS) of the motor cortex has been shown to be effective to treat chronic pain, essentially neuropathic pain. We propose to test the efficacy of tDCS in patients experiencing cancer pain in the palliative care setting. Method/design This article describes the protocol of a bicentre, randomized, parallel-arm, sham-controlled clinical trial evaluating tDCS in the treatment of palliative care patients with refractory cancer pain. Seventy patients between the ages of 18 and 80 years experiencing refractory pain with a pain score of 4/10 on a numerical rating scale (NRS) ranging from 0 to 10 will be enrolled in this trial. The main exclusion criteria are patients unable to fill in the various rating scales and life expectancy less than 3 weeks. Treatment consists of 5 consecutive tDCS sessions targeting the motor cortex (one daily session for 5 days) on the contralateral side to the pain. After randomization (1:1 ratio), 35 patients will receive active stimulation and 35 patients will receive sham stimulation. The primary endpoint is the NRS score and the primary objective is a significant improvement of this score between the baseline score recorded between D-3 and D-1 and the score recorded 4 days after stopping treatment (D8). The secondary objectives are to evaluate whether this improvement is maintained 16 days after stopping treatment (D21) and whether the following scores are improved on D14 and D21: Brief Pain Inventory, Edmonton Symptom Assessment System, Hospital Anxiety and Depression scale, State-Trait Anxiety Inventory and Medication Quantification Scale. Discussion Positive results of this trial would indicate that tDCS can improve pain and quality of life of cancer patients in the palliative care setting. Reduction of analgesic consumption and improvement of activities of daily living should allow many patients to return home with a decreased workload for caregivers.

Douleur Et Analgesie, Sep 1, 2003

la participation à son équipe d'un médecin-conseil. Le praticien, en poste dans l'établissement, ... more la participation à son équipe d'un médecin-conseil. Le praticien, en poste dans l'établissement, est naturellement devenu le parte-naire spécifique de cette activité. Il y trouve un grand intérêt. Le désir d'explication des positions adoptées par l'assurance maladie, le rôle d'interface entre les univers du soin et de la protection sociale prennent tout leur sens dans une fonction d'accompagnement de la structure hospitalière mais aussi des malades. Il participe régulièrement aux staffs de l'équipe pluridisciplinaire, rencontre, à la demande, les patients qui souhaitent un dialogue avec lui et rend compte de son point de vue au responsable du centre, mais aussi souvent, avec l'accord du patient, au médecin conseil du patient.

Joint Bone Spine, May 1, 2023

BMJ Supportive & Palliative Care

ObjectivesLimited descriptive data are available on continuous and deep sedation maintained until... more ObjectivesLimited descriptive data are available on continuous and deep sedation maintained until death (CDSUD) at the patient’s request in palliative care units. This study aimed to describe such practices in the context of refractory suffering or after a request to stop life-sustaining treatment, evaluating the duration and dosage of sedative treatments used.MethodsThis retrospective observational study included consecutively hospitalised patients in a palliative care unit from January 2020 to December 2021. Data on patient profiles, reasons for the sedation request, duration of sedation and doses of sedatives were collected.ResultsAmong 42 patients who underwent CDSUD, 79% occurred due to refractory suffering. In cases of sedation following a request to stop life support, high-dose corticosteroid therapy was the most commonly involved life-sustaining treatment. Midazolam was always the first-line sedative treatment. Chlorpromazine was added in 79% of cases, and propofol in 40%, t...