Hypnotherapy and insomnia: A narrative review of the literature.

INTRODUCTION: Hypnotherapy is increasingly used in general medicine in France to manage health problems such as insomnia. There is some evidence to support the efficacy of hypnosis in treating insomnia but this evidence is based on methodologies of various strengths. This review aims to explore the methodological elements employed in hypnotherapy research to manage insomnia. METHOD: We performed a narrative review of the literature using systematic review methods focusing on treating insomnia with hypnosis. PubMed, Psycinfo, BASE and Cochrane databases and Google scholar were searched. RESULTS: Overall, 25 studies were included consisting of 10 case studies, 11 randomised, controlled trials and 4 pre and post intervention studies. The study designs, intervention, control and comparators were heterogeneous, as were the hypnosis definitions and techniques. Also, detailed descriptions of the hypnosis techniques were lacking. Most studies used non-quantifiable measurement criteria and sample numbers were too small to show significance or be representative. No double-blind study was found. CONCLUSION: Our results indicate that the current research concerning the efficacy of hypnosis to relieve insomnia is lacking in key methodological elements. The evaluation research process requires robust methodology. We propose applying the IDEAL framework, which recommends research steps to evaluate non-pharmacological and other complex therapies to evaluate the efficacy of hypnosis to manage insomnia.

[A Listeria breast abscess in a man]. / Un abcès du sein à Listeria chez un homme.

INTRODUCTION: Listeriosis is a food-borne illness leading to bacteriemia or central nervous system infection especially in pregnant women or high-risk patients. It is rarely a localized infection. Breast contamination has rarely been reported in lactating women. We report a breast abscess in man. CASE REPORT: A 80 year old man, hypertensive and arrhythmic, was explored for weakness and dehydration. Type 2 diabetes and chronic lymphocytic leukemia were diagnosed. Clinical examination disclosed a breast abcess related to L monocytogenes infection. Histopathological study also revealed a breast subcutaneous infiltration by chronic lymphocytic leukemia. CONCLUSION: Listeriosis sometimes uncover an unknown immunosuppression, especially in the elderly. Breast is a non-sterile tissue containing a stable microbiome partly from digestive origin. It can thereby be contaminated by Listeria. The specific cutaneous infiltrate of chronic lymphocytic leukemia can create the conditions for a local infection.