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Wosinski B, Le Breton J, Soroken C. [Hypnosis: a complementary tool for managing adolescents affected by anorexia nervosa]. Rev Med Suisse 2024; 20:793-796. [PMID: 38630039 DOI: 10.53738/revmed.2024.20.870.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Anorexia Nervosa (AN) mainly affects adolescent girls and requires specialized, multidisciplinary care. In Geneva, the HUG's AliNEA unit and the pediatric hypnosis consultation have been collaborating since 2021 to integrate hypnosis into the management of AN. Hypnosis is seen as a complementary tool to the Maudsley therapeutic model, but not a miracle solution. It needs to be adapted to each patient's individual needs and to the different phases of treatment : re-association with the body, reinforcement of motivation, exploration of interpersonal relationships and consolidation of progress. Although scientific evidence is limited, patient testimonials underline its beneficial potential as a non-medicinal, individualized form of support.
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Affiliation(s)
- Benjy Wosinski
- Consultation d'hypnose médicale pédiatrique, Service de pédiatrie générale, Hôpitaux universitaires de Genève, 1211 Genève 14
| | | | - Cindy Soroken
- Unité alimentation et nutrition chez l'enfant et l'adolescent (AliNEA), Consultation ambulatoire pour la santé des adolescents et des jeunes adultes, Service de pédiatrie générale, Hôpitaux universitaires de Genève, 1211 Genève 14
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2
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Tzieropoulos Osterlof H, Wegmüller G, Vust S, Lier F, Savoia M, Soroken C. [Eating disorders in the light of addiction]. Rev Med Suisse 2024; 20:382-387. [PMID: 38380659 DOI: 10.53738/revmed.2024.20.862.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Eating disorders (ED) are complex and damaging to health. They cause suffering similar to that of addictions. Although they share some similarities, eating disorders remain distinct from addictions. Fundamental differences emerge in binge eating and restrictive behaviors. Eating disorder treatment in adolescents relies mainly on family therapy and can incorporate a reflection on these similarities and differences. For instance, understanding the addictive nature of the illness helps parents and patients to avoid sterile negotiations around food. An individualized approach is crucial to the effective management of ED by a specialized multidisciplinary team. Clarity in explaining physiological mechanisms strengthens the therapeutic alliance.
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Affiliation(s)
- Hélène Tzieropoulos Osterlof
- PhD, Psychologue cadre, Consultation ambulatoire TCA, Service universitaire de psychiatrie de l'enfant et adolescent, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Guillaume Wegmüller
- Division interdisciplinaire de santé des adolescents, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Sophie Vust
- PhD, Psychologue cadre, Division interdisciplinaire de santé des adolescents, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Françoise Lier
- Division interdisciplinaire de santé des adolescents, Centre vaudois anorexie boulimie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Marco Savoia
- Pédopsychiatre, Unité alimentation et nutrition chez l'enfant et l'adolescent, Service de psychiatrie de l'enfant et l'adolescent, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Cindy Soroken
- Unité alimentation et nutrition chez l'enfant et l'adolescent, Consultation ambulatoire pour la santé des adolescents et des jeunes adultes, Service de pédiatrie générale, Hôpitaux universitaires de Genève, 1211 Genève 14
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3
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Soroken C, Posfay-Barbe KM, Caflisch M, Z'Graggen WJ. Postural tachycardia syndrome among adolescents. Arch Pediatr 2022; 29:398-403. [PMID: 35523634 DOI: 10.1016/j.arcped.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/20/2022] [Accepted: 03/26/2022] [Indexed: 12/01/2022]
Abstract
Postural tachycardia syndrome (PoTS) is a polymorphic clinical syndrome that is underdiagnosed, especially in adolescents. It is a form of dysautonomia, but its exact physiopathology remains elusive. Several pathologies can mimic PoTS; it is characterized by heterogeneous symptoms that accompany a disproportionate tachycardia upon the upright position. It can significantly impact the patients' quality of life. Only a Schellong test is useful for making the diagnosis. Treatment in PoTS is primarily symptomatic with the main goal being to restore the patient's condition as quickly as possible. We report here the diagnosis and management of seven adolescents, aged 11-16, who have been followed up since 2015.
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Affiliation(s)
- C Soroken
- Department of Pediatrics, Geneva University Hospitals, Willy-Donzé Street 6, 1205 Geneva, Switzerland.
| | - K M Posfay-Barbe
- Department of Pediatrics, Geneva University Hospitals, Willy-Donzé Street 6, 1205 Geneva, Switzerland
| | - M Caflisch
- Department of Pediatrics, Geneva University Hospitals, Willy-Donzé Street 6, 1205 Geneva, Switzerland
| | - W J Z'Graggen
- Departments of Neurology and Neurosurgery, Inselspital, Bern University Hospital, Freiburgstrasse 16, 3010 Bern, Switzerland
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Soroken C, Le Breton J. [Postural tachycardia syndrome among adolescents]. Rev Med Suisse 2022; 18:741-745. [PMID: 35451277 DOI: 10.53738/revmed.2022.18.778.741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Postural tachycardia syndrome (PoTS) is a frequent polymorphic clinical syndrome, poorly known and, as a result, underdiagnosed especially in adolescents. It is a form of dysautonomia, but its exact physiopathology remains elusive. It is characterized by heterogeneous symptoms that accompany a disproportionate tachycardia upon the upright position. It can significantly impact adolescents' quality of life. Only a Schellong test is useful to make the diagnosis; however additional testing is frequently performed in order to exclude conditions that may mimic, exacerbate or impact management. Treatment in PoTS is primarily symptomatic. The main goal is to restore the patient's condition as quickly as possible. Its management is multidisciplinary and must involve the parents. The course of the syndrome is sometimes marked by relapses, but the prognosis is mostly favorable.
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Affiliation(s)
- Cindy Soroken
- Consultation de médecine des adolescent-e-s, Service de pédiatrie générale, Département de la femme, de l'enfant et de l'adolescent, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Julien Le Breton
- Service de gériatrie, Département de réadaptation et gériatrie, Hôpitaux universitaires de Genève, 1211 Genève 14
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Najjar I, Socquet J, Gayet-Ageron A, Ricou B, Le Breton J, Rossel A, Abdulcadir J, Soroken C, Tessitore E, Gerstel C, Halimi J, Frasca Polara G, Coen M, Niyibizi E. Prevalence and forms of gender discrimination and sexual harassment among medical students and physicians in French-speaking Switzerland: a survey. BMJ Open 2022; 12:e049520. [PMID: 35039283 PMCID: PMC8765015 DOI: 10.1136/bmjopen-2021-049520] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine the prevalence and forms of gender discrimination and sexual harassment experienced by medical students and physicians in French-speaking part of Switzerland. DESIGN AND SETTING We conducted an online survey using a questionnaire of 9 multiple-choice and 2 open questions between 24 January 2019 and 24 February 2019. Our target population was medical students and physicians working at hospitals and general practitioners from the French-speaking part of Switzerland. The online survey was sent via social media platforms and direct emails. We compared answers between male-determined and female-determined respondents using either χ2 or Fisher's exact tests. RESULTS Among 1071 responders, a total of 893 were included (625 females, 264 males, 4 non-binary and 1 non-binary and male). 178 were excluded because they did not mention their working place or were working only outside Switzerland. Because of the small number of non-binary participants, they were not contemplated in further statistical analysis. Of 889 participants left, 199 (31.8%) women and 18 (6.8%) men reported having personally experienced gender discrimination, in terms of sexism, difficulties in career development and psychological pressure. Among women, senior attendings were the most affected (55.2%), followed by residents (44.1%) and junior attendings (41.1%). Sexual harassment was equally observed among women (19.0%) and men (16.7%). Compared with men (47.0%), women (61.4%) expressed the need to promote equality and inclusivity in medicine more frequently (p<0.001), as well as the need for support in their professional development (38.7% women and 23.9% men; p<0.001). CONCLUSIONS Gender discrimination in medicine in French-speaking Switzerland affects one-third of women, in particular, those working in hospital settings and senior positions.
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Affiliation(s)
- Iris Najjar
- Department of Medicine, HUG, Geneva, Switzerland
| | | | | | - Bara Ricou
- Department of APSI, HUG, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Julien Le Breton
- Department of Rehabilitation and Geriatrics, HUG, Geneva, Switzerland
| | - Anne Rossel
- Department of Medicine, HUG, Geneva, Switzerland
| | | | - Cindy Soroken
- Department of Maternity, Adolescent and Child Health, HUG, Geneva, Switzerland
| | | | - Caroline Gerstel
- Department of General Internal Medicine, Delta Practice Network, Geneva, Switzerland
| | - Julie Halimi
- Department of Child Psychiatry, HUG, Geneva, Switzerland
| | | | - Matteo Coen
- Department of Medicine, HUG, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Eva Niyibizi
- Deprtment of Emergency Care, Hirslanden Clinique La Colline, Geneva, Switzerland
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Varatharaju V, Caflisch M, Soroken C, Kiliaridis S, Antonarakis GS. Does age influence self-perception of the soft-tissue profile in children? Am J Orthod Dentofacial Orthop 2021; 159:e207-e215. [PMID: 33461898 DOI: 10.1016/j.ajodo.2020.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Appreciation of the soft-tissue profile is important in orthodontic diagnosis and treatment. However, are the patients themselves aware of their profile appearance? We aimed to evaluate if age influences self-perception of the soft-tissue profile in children. METHODS The study population for this prospective cross-sectional investigation consisted of 3 groups of 60 patients, classified according to age (<12 years; 12-15 years; >15 years). Each subject's right-sided facial profile was photographed to obtain a silhouette. Facial profile silhouette templates were created to represent the local population. Each subject's photograph was inserted into the corresponding template, and the subjects were asked to identify themselves. Facial profile self-recognition was recorded as a binary variable (yes or no). Other recorded variables included age, sex, and sexual maturity rating (using Tanner staging). Chi-square tests were used to analyze facial profile self-recognition between different subgroups, and stepwise multiple regression was used to predict the probabilities of facial profile self-recognition, with age, sexual maturity rating, and other recorded variables as independent variables. RESULTS Eighty percent of subjects aged >15 years recognized their own profile, compared with only 55% and 50% of subjects aged 12-15 years and <12 years, respectively. Subjects aged >15 years were significantly more likely to recognize their profile than younger subjects (P = 0.001). Similarly, subjects with the most advanced sexual maturity rating (stage V) were significantly more likely to recognize their profile (85% self-recognition) than those in groups I-IV (P <0.001). Girls were more likely to recognize their profiles than boys (P = 0.028). When using multiple regression analysis, sexual maturity rating appears to be the only significant predictor for facial profile self-recognition (R2 = 0.25; P <0.001). CONCLUSIONS Facial profile self-recognition seems to improve with age and sexual maturity (sexual maturity rating stage V). Because orthodontic treatment planning takes possible soft-tissue changes into account, it is important to evaluate the degree of self-perception of the patients to adapt our goals and treatment discussions.
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Affiliation(s)
- Vysnave Varatharaju
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
| | - Marianne Caflisch
- Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Cindy Soroken
- Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Stavros Kiliaridis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Gregory S Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Wahlen R, Brockmann C, Soroken C, Bertholet L, Yaron M, Zufferey A, Ambresin AE, Merglen A. [Transgender and non-binary teenagers : management in primary care]. Rev Med Suisse 2020; 16:789-793. [PMID: 32320155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Transgender, non-binary and questioning teenagers are increasingly visible. However, they face barriers in accessing appropriate care that meet their needs, both specific and regarding their general health. Primary care physicians increasingly see them in consultations but often lack elements of communication and recent knowledge that is needed to accompany them and their close ones in their -individual trajectories. This article aims to answer this need and provides a synthesis about recent evidence and suggested communication approaches for primary care physicians, who play a central role for the health of all patients.
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Affiliation(s)
- Raphaël Wahlen
- Division interdisciplinaire de santé des adolescents, CHUV, Université de Lausanne, 1011 Lausanne
| | - Céline Brockmann
- Comité directeur du Bioscope, Faculté de médecine, Université de Genève, 24 rue du Général-Dufour, 1211 Genève 4
| | - Cindy Soroken
- Consultation des adolescents, Service de pédiatrie générale, Département de la femme, de l'enfant et de l'adolescent, HUG, 1211 Genève 14
| | | | - Michal Yaron
- Consultation de gynécologie pédiatrique et des adolescentes, Unité santé jeunes, Service de gynécologie, Service de pédiatrie générale, Département de la femme, de l'enfant et de l'adolescent, HUG, 1211 Genève 14
| | | | - Anne-Emmanuelle Ambresin
- Division interdisciplinaire de santé des adolescents, CHUV, Université de Lausanne, 1011 Lausanne
| | - Arnaud Merglen
- Unités de pédiatrie hospitalière, Consultation des adolescents, Unité santé jeunes, Service de pédiatrie générale, Département de la femme, de l'enfant et de l'adolescent, HUG, 1211 Genève 14, et Faculté de médecine, Université de Genève, 24 rue du Général-Dufour, 1211 Genève 4
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Yaron M, Soroken C, Narring F, Brockmann C, Merglen A. [Adolescence and sexuality: a risky business How best to inform parents ?]. Rev Med Suisse 2018; 14:843-848. [PMID: 29668148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Parents are often reluctant to discuss sexuality and romantic relationships with their teenagers. However, these discussions can have a strong impact on their children's health. Care providers can act as a reliable source of information to support parents in this task. Through repeated short interactions with their child over their adolescence, parents can cover most topics related to sexuality, based on teenagers' questions and the situations that they face (e.g. LGBT bullying at school). This article summarizes current best practice on how to facilitate parental dialogue with adolescents about sexuality and offer care providers guidance in transmitting this information to parents.
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Affiliation(s)
- Michal Yaron
- Consultation de gynécologie pédiatrique et des adolescentes, Unité santé jeunes ; Service de gynécologie, Département de gynécologie obstétrique, Service de pédiatrie générale, Département de l'enfant et de l'adolescent, HUG, 1211 Genève 14
| | - Cindy Soroken
- Consultation des adolescents, Service de pédiatrie générale, Département de l'enfant et de l'adolescent, HUG, 1211 Genève 14
| | - Françoise Narring
- Unité santé Jeunes, Service de pédiatrie générale, Département de l'enfant et de l'adolescent et Département de médecine communautaire, de premier recours et des urgences, HUG, 1211 Genève 14 et Université de Genève, 1211 Genève 4
| | - Céline Brockmann
- Comité directeur du Bioscope, Université de Genève, 1211 Genève 4
| | - Arnaud Merglen
- Unités de pédiatrie hospitalière, Consultation des adolescents et Unité santé jeunes ; Service de pédiatrie générale, Département de l'enfant et de l'adolescent, HUG, 1211 Genève 14 et Département de pédiatrie, Faculté de médecine, Université de Genève, 1211 Genève 4
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Soroken C, Lacroix L, Korff CM. Combined VIth and VIIth nerve palsy: Consider idiopathic intracranial hypertension! Eur J Paediatr Neurol 2016; 20:336-338. [PMID: 26653361 DOI: 10.1016/j.ejpn.2015.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Idiopathic intracranial hypertension (IIH) is a rare condition in children. VIth nerve palsy is the most common cranial nerve deficit related to that condition. Other cranial nerve dysfunctions have also been described but remain rare in paediatric daily practice. CASE PRESENTATION We here report the case of a 13-year-old girl who presented with VIth and contralateral VIIth nerve palsy due to IIH. CONCLUSION Although rarely encountered, paediatricians should be familiar with the possible association of VIth and contralateral VIIth nerve palsy in children suffering from IIH. Moreover, other cranial nerve deficits may also be affected.
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Affiliation(s)
- Cindy Soroken
- Paediatric Emergency Medicine Department, Child and Adolescent Medicine, Geneva University Hospitals, Geneva, Switzerland.
| | - Laurence Lacroix
- Paediatric Emergency Medicine Department, Child and Adolescent Medicine, Geneva University Hospitals, Geneva, Switzerland.
| | - Christian M Korff
- Paediatric Neurology, Child and Adolescent Department, University Hospitals, Geneva, Switzerland.
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Soroken C, Frangos E, Tarteaut MH, Vischer U. The paradoxical effect of malnutrition treatment on diabetes control and wound healing. Eur Geriatr Med 2012. [DOI: 10.1016/j.eurger.2011.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Soroken C, Zarate M, Perrenoud J. Takotsubo cardiomyopathy as a consequence of a fall in an asymptomatic geriatric patient. Eur Geriatr Med 2011. [DOI: 10.1016/j.eurger.2011.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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