My initial contact with muscular dystrophy, especially with the Duchenne type (DMD), symbolized the abnegation of the caregivers of the time (Fig. 1). The isolation of the diseased children in specialist centers constituted the basis of the recommendations in France during the 1970s. For this reason, five of them were permanently hospitalized in the medical rehabilitation department of Poitiers hospital, on the hope that contemporary techniques could counteract some of the disease’s

Inhibitors,research,lifescience,medical deleterious effects. The first lesson received at that time was the result of a family’s revolt: “Where do you get the right to deprive my brother of what’s left of his freedom during the little time he has still to live?”. My response

consisted in stressing the exigencies of an optimal medical Inhibitors,research,lifescience,medical care. Shortly thereafter, the boy passed away. That was when I realized that I needed to modify my approach and my techniques. Figure 1. Body status seen in the 1970s in an adolescent suffering from a very Inhibitors,research,lifescience,medical rapidly evolving DMD; death at the age of 16 years. The rare studies insisting on a comfortable life for DMD patients originated for the most part in the United States. They selleck chemicals llc carefully attempted to prolong the ambulatory stage by bracing, after a surgical correction which was contraindicated in France. The eminent defender of this kind of management in the 1960s, Paul J. Vignos, was in charge of the one of the medicine departments of the University of Cleveland, Ohio. The initial rule that he promulgated, firmly excluded prolonged bedrest: “The duration of Inhibitors,research,lifescience,medical enforced immobilization in bed or in a wheelchair should be kept

to a minimum during an intercurrent acute Inhibitors,research,lifescience,medical illness [...] This allows an active physical therapy program to be prescribed that will help minimize disuse atrophy [...] This prescription, for such a combined activity program, should be given to neuromuscular disease patients if it is anticipated the illness will require bedrest for longer than 4-5 days”. I was fortunate enough to be introduced to this country in 1972 thanks to professor A. Cournand, from the Columbia University, winner Rutecarpine of a medicine Nobel Prize for his work in the cardio-respiratory area and for his discovery of cardiac catheters. Following my requests, he informed me that I needed to start by observing carefully the problems I wished to solve, without thereby neglecting the patient in his integrity. He affirmed that “when knowledge of the clinical course became clear, therapeutic decisions would come much more easily”. He then advised me to visit a specialized unit devoted to respiratory assistance in Goldwater Memorial Hospital, which was part of the New York University Medical Center.