Affections Longue Durée translation

[Nickel]

19) Néphropathie chronique grave et Syndrome néphrotique pur primitif

Chronic Renal (Kidney) Disease - Primary Nephrotic syndrome

1) Chronic Renal Disease - including Glomerulonephritis, Pyelonephritis, Interstitial Nephritis, Hereditary and Congenital Kidney Disease.

A progressive loss of renal function. Usual underlying causes are Diabetes - Hypertension - Glomerulonephritis.

They are considered severe based on various clinical /biological examinations e;g permanent hypertension problems with metabolism

Therapy consists of treating the primary cause -(if possible) and/or treating the secondary  effects in an attempt to slow down the progress which in turn may lead to kidney failure requiring dialysis or transplant.

*  chronic renal disease is exempt

2) Primary Nephrotic Syndrome. A disorder of the kidneys whereby they "leak" large amounts of protein into the urine.

Treatment consists of supportive measures and immunosuppressives ( steroids)

Prognosis - can be mild and with long remissions or lead to renal failure

* may be exempt depending on severity

 

[Nickel]

20) Paraplégie

Paraplegia. Impairment in nerve function of lower body- loss of ability to move/feel both legs and lower trunk.

Multiple causes - Lesions of the peripheral nerves - Spinal cord ( the level of injury is important ).Brain lesions  and congenital disorders

Commonest cause is due to trauma  

*Whatever the cause exemption is granted when the condition is "disabling"

Some situations are reversible in which case the exemption will be removed, others of course may lead to a progressive and permanent disability requiring prolonged care and support.

 

[Nickel]

21) Périartérite Noueuse, Lupus Erythémateux Aigue Disséminé, Sclérodermie Généralisée Evolutive.

Periarteritis Nodosa,   Systemic Lupus Erythematosus,   Progressive Systemic Scleroderma.

Auto-immune Chronic Inflammatory Connective Tissue Diseases

1) Periarteritis Nodosa -Covers a large number of diseases that affect the small arteries -Because many organs may be affected the clinical signs are very varied. It is a serious disorder requiring immuno-suppressives and steroid treatment, a lot will depend on the specific organ damage.

* If limited just to skin lesions it may not be exempt

2) Systemic(disseminated) Lupus Erythematosus. A serious disease with a varied presentation affecting many organs of the body- heart, lungs, kidneys, liver, brain, skin and therefore can produce a large range of symptoms   Probably genetic predisposition with environmental triggers. Periods of remission and illness (flares) Treatment is symptomatic and huge advances have been made in the understanding of this disease

*Discoid lupus which is mainly confined to skin and Drug Induced Lupus ( many drugs can produce symptoms of lupus) are not exempt*

3) Progressive Systemic Scleroderma -A serious and rare disease causing thickening and tightening of connective tissue. Outcome depends on organs involved e.g severe lung /kidney involvement. The diffuse and CREST types are exempt

* Localised scleroderma - usually (but not always ) confined to the skin - rarely develops into the systemic scleroderma and may not be exempt.

 

[Nickel]

22) Polyarthrite Rhumatoide Evolutive Grave

Rheumatoid Arthritis - Chronic inflammatory auto-immune disease affecting many of the joints in the body

Painful condition causing destruction of the joints and loss of mobilty with increasing disability.Slow onset usually affecting small joints of hands and feet and may progress to larger joints. The inflammatory changes can affect other organs - liver, lungs, heart etc.

Diagnosis is made from a list of 7 criteria of which 4 are necessary to confirm.

Some have mild symptoms but for the majority of sufferers the disease steadily progresses to substantial functional disability.

A number of advances are being made in drug  treatments along with the importance of  rest and physical activity.

There are many other chronic arthritic diseases e.g psoriatic arthritis which also have exemption and others still such as Crohn's disease which are listed separately.

 

 

 

[Gardian]

This is invaluable stuff.  Not sure if it's been mentioned, but when finished, it needs to go up as an FAQ in the appropriate section.

Not long to go Nickel !!

[Nickel]

Gardian

Thanks for your support - I am just sorry it is taking much longer than I thought it would !! Psychosis today - !!

[AnOther]

Nearly there now.

I'm sure the torrent of appreciation will follow [:D]

[Nickel]

23) Psychose, Trouble grave de la personnalité, Arriérations Mentale.

Psychosis, Severe personality disorders, Mental Retardation ( this term is  no longer used  in UK/US and Learning Difficulties, Severe mental impairment - Intellectual and Developmental Disabilities are current terminologies)

A huge range of disorders,  not easily classified, with crossing-over between "psychiatric " and "neurological" causes.

1) Psychosis. - Severe mental disorder - derangement of personality and loss of contact with reality. It is really a symptom of other disorders

Includes - Schizophrenia, Bipolar disorder,Unipolar disorder( severe clinical depression) Delerium.

Initial exemption of 6 months as condition assessed with renewal though some acute psychoses will not be covered.

2) Severe Personality disorders -  Behaviour that deviates markedly from expectations of individual's culture. A very broad range of disorders. e;g Histrionic, obsessional, phobic,anxiety,etc etc.

3) Mental Impairment. This group includes the developmental disabilities manifesting in childhood - cerebral palsy, autism, Down's etc etc

and also the dementias occuring in older age group no matter what the cause , e.g Alzheimer's,  Pick's disease, senile dementia.

Exemption depends on severity, many minor or transitory problems will not be exempt. Alcohol and drug dependency can produce a number  of neurological - psychological  problems - psychosis - dementia - personality disorder - depression etc

* This somewhat oversimplifies a very large and varied group of  disorders

  

 

 

[Nickel]

24) Recto-colite hémorragique et Maladie de Crohn évolutive

Ulcerative Colitis   and Crohn's Disease

1) Ulcerative Colitis - Chronic Inflammatory Bowel Disease ( not to be confused with irritable bowel syndrome) affects colon/ rectum but is also a systemic disease so other organs may be affected. Clinical diagnosis +/- endoscopy(sigmoidoscopy) May be mild to very severe requiring hospitalisation and surgery, may require partial or total colectomy ( the latter amounting to a cure)  If disease is widespread it carries a risk of cancer.

Exemption depending on severity, initially for 1 year when reassessed. If quiescent and improvement shown on endoscopy  may no longer be exempt even if on continued specific medication.

2) Crohn's Disease - Chronic Inflammatory Bowel Disease,  can affect the entire digestive tract. Also systemic so may affect other parts of the body - esp eyes/ joints. Diagnosis - by clinical, radiology and biopsy.

Symptoms are diarrhoea and abdominal pain -  May be strictures (obstructions) in the intestines with abscesses and perforations.

Surgery may be required to remove affected lengths of bowel. there is no cure, people experience remissions and "flares".

Treatment - treat acute episodes and maintain remissions - surgery - anti inflammatory and immunosuppressive medication. Also carries an increased risk of bowel cancer.

All Crohn's disease is exempt unless very mild and not requiring regular treatment nor showing signs of recurring after 2 years.

* Although both conditions do carry an increased incidence of bowel cancer - these patients tend to have more frequent investigations than the general population and it is likely that their cancer will be diagnosed and treated early *

 

 

 

 

 

 

[Nickel]

25) Sclérose en Plaques Invalidante

Mutiple Sclerosis.  A chronic inflammatory disease of the Central Nervous System whereby the fatty sheaths around the nerve are destroyed resulting in loss of transmission of the "nerve/electrical"  impulses.

Usually occurs with  "attacks" of loss of sensation ( most common)  or muscle weakness, maybe speech problems or eye signs.This may be transitory  so a diagnosis may not be made. May be months or even years before the next attack. gradually becomes more progressive with less remissions.

During attacks neurological symptoms may be severe requiring hospitalisation.

Exemption for 6 months following any attack and each new attack gaining a similar exemption but as the disease progresses to possibly cause severe disability exemption will be  granted

 

 

 

[Chris]

What a fascinating and valuable list - can I ask a question, or should I wait until the end to avoid interrupting the flow of information?

[Nickel]

26) Scoliose structurale évolutive( dont l'angle est egal ou supérieur à 25° ) jusqu'à maturation rachidienne.

Progressive Scoliosis (where the angle is equal or more than 25°) up to spinal maturity.

Permanent lateral deviation of the spine with rotation of the vertebral bodies.

Cause uncertain but may run in families usually diagnosed in middle childhood though some scolioses are apparent at birth due to Spina bifida, cerebral palsy etc.

Tends to progress, the 25° angle is an indication of severity. Basis of treatment is to obtain by the end of growth a spine as straight and balanced as possible, by use of plasters, corsets, surgery.

Exemption for scolioses of 25° and above and for infantile scolioses of a smaller angle requiring orthopaedic treatment.

[Nickel]

[quote user="Chris"]What a fascinating and valuable list - can I ask a question, or should I wait until the end to avoid interrupting the flow of information?[/quote]

Sorry just seen your post - 4 more to go - so a couple of days left ! if your question is about the translation please feel free to ask .

 

[Nickel]

27) Spondylarthrite Ankylosante Grave

Ankylosing Spondylitis.  Chronic degenerative inflammatory disease of Spine. Onset insidious - repeated back ache in young age group.

Diagnosis by clinical, radiology and some specific blood tests.

 May be mild but tends to progress and bones of the spinal column fuse together ( ankylosis) causing severe handicap.It is a systemic disease so other organs - eyes, heart,kidneys may be affected. May be secondary to other disease processes e.g Reiter disease / Crohn's/ Ulcerative Colitis

Treatment - No cure - anti-inflammatory - immuno-suppressive medication - Physical therapy (swimming,yoga ,tai-chi etc) and surgery. 

*Exemption as are some of the primary causes e.g Crohn's 

[Nickel]

28) Suites de transplantation d'organe

Organ transplants - Post- operative care

Organ transplants include kidney, heart, liver, pancreas, lung, intestines and by extension bone marrow.

All exempt because of continuing follow-ups including  immuno-suppressive medication, assessment of transplant and  monitoring of any complications ( rejection, infection etc)

Corneal transplants are not exempt unless systemic immuno-suppressive medication required - when exemption is for 1 year and is renewable

[AnOther]

Hoorah, well done Nikel, thank you very much [:D][:D][:D]

I see you're in Lot so I'll be happy to buy you a [B] if we ever happen to meet.

Ernie

[Nickel]

steady on Ernie, still 2 to go !!!!

[Nickel]

29) Tuberculose active

Active Tuberculosis. A common and serious infectious disease,caused by a Mycobacterium.  Usually affects lungs but can involve other organs.

Although a common infection throughout the world most people who are infected have a "latent" asymptomatic form. This may however progress to active disease (10%) and this is a serious condition requiring long-term medication ( up to a year) of 2 or more drugs

Diagnosis is by isolating the organism or microscopic study of the lesions, however, treatment may begin on clinical diagnosis before confirmed diagnosis.

Seen more often now in people with a compromised immunology ( due to immuno-suppressive medication or disease e.g AIDS) and due to widespread travel to regions where Tuberculosis is common

Treatment effective so exemption is granted but  reviewed on 6 month /yearly basis - when "cured" subsequent radiological follow-up may not be exempt.

 

 

[AnOther]

Oops, I see you did say the OTHER 28 in your OP [:$]

[Nickel]

And now I discover there is an ALD 31 and ALD 32 !!

[Nickel]

30) Tumeur maligne, affection maligne du tissue lymphatique ou hématopoietique.

Malignant cancer and cancer of the lymph or blood system.

Malignant cancer occurs when certain cells start to grow and invade the surrounding tissues and may spread to other parts of the body.

An enormous number of different cancers can occur depending on the originating cell type.

Diagnosis is made on clinical, radiological imaging,and definitive diagnosis on histological examination of a biopsy .

Advances are continually being made in the understanding of causes and treatment of cancers, ( too many to warrant inclusion here) which may involve surgery, chemotherapy, radiotherapy.

Exemption depends on the specific cancer,staging,prognosis, treatment etc etc.

ALD 31) and ALD32)

Exemption may also be granted for :

ALD 31 a serious disease not in the above categories where continuous care is anticipated to last for a minimum of 6 months - examples stated  are - Macular degeneration ( commonest cause of blindness in people over 50)  Xeroderma Pigmentosum.

ALD 32 where several diseases may be present, again where continuous care is anticipated to last for a minimum of 6 months an example

given is of an elderly blind person who suffers a hip fracture. a so-called Polypathology.

 

[Nickel]

I hope there are not too many  errors - please let me know if you find any so they can be edited for future use.
I have tried to be concise and by being so will have left out so much important information, but I trust it gives a slightly better understanding of the chronic conditions.

As for the exemptions and methods of exemption, well that probably requires another thread entirely!!

There seems to be a lot of revision (political,financial and medical) at the moment with the entire list subject to constant updating and revision.
There are plenty of guidelines for patients and doctors which are also under review. (see Haute Authorité de Santé - with many articles in English).
Apparently 8 million patients are included in the ALD system and the care accounts for over half of the total expenses reimbursed by the Assurance Maladie.

 

[Chris]

Thank you - what a useful list, which I'm sure will be informative to many. On reading the list, my question is whether, having Alternative Plumbing (circumlocution for the squeamish!) as a result of previous bowel cancer, I would have to pay for the necessary regular supplies currently provided free in UK under a medical exemption certificate. Any ideas, please?

[Russethouse]

Chris, I think you should start another thread so that other forum members see your question. Its a bit hidden here.

[Chris]

OK - I'll do that. Thanks!