Quelle place pour la psychothérapie dans la psychiatrie publique [What place for psychotherapy in public psychiatry?].

The question of the place of psychotherapy in psychiatric public care is posed in this article. We will address this question first by presenting two clinical and research programmes which were implemented in a clinical psychiatric unit, section Karl Jaspers (Service of General Psychiatry) of the Department of Psychiatry CHUV, in Lausanne with the collaboration of the University Institute of Psychotherapy. The first one puts forward psychodynamic psychotherapy of depressed inpatients; the clinical programme and the research questions on efficacy of this treatment are discussed. The second focuses on the early treatment of patients with Borderline Personality Disorder, in particular in its research question on the effect of the motive-oriented therapeutic relationship in this process. We conclude by underlining the convergences of the two programmes.

Le théologien, 'intellectuel organique' et chercheur indépendant : quelle loyauté, quelles tensions, quelle liberté ?

L'auteur s'interroge sur la catégorie d'intellectuel organique, que le philosophe marxiste Antonio Gramsci avait appliquée à l'Église catholique. Une relecture de ce concept conduit à développer un portrait critique du théologien comme penseur ecclésial, universitaire et public (à la suite de David Tracy). Cette triple appartenance du théologien, bien comprise, n'est pas contraire à sa liberté de parole et d'action, liberté qui découle de l'Évangile et qui peut s'affirmer dans le contexte d'une modernité revisitée. La tradition protestante offre une vision dynamique et réaliste de cette liberté du théologien, comprise comme loyauté critique, sans rien nier des tensions et des contraintes qui sont les siennes. The author examines the category of organic intellectual, applied by the Marxist philosopher Antonio Gramsci to the Catholic Church. A new interpretation of this category allows to develop a critical portrait of the theologian as ecclesial, academic and public thinker (following David Tracy). The well-interpreted dependence of the theologian towards church, university and society is not contradictory to his freedom of speech and action. This freedom is a consequence of the Gospel and has a good impact in the context of a revisited modernity. The protestant tradition offers a dynamic and realistic vision of such a freedom of the theologian, understood as critical loyalty, without denying the tensions and the constraints inherent to his or her situation.

Aptitude au volant: quelle conduite pour les médecins en 2008? [Fitness to drive: which assessment by doctors in 2008?]

La fréquence et la complexité des problèmes médicaux qui concernent la conduite automobile augmentent progressivement. Dans la plupart des cantons suisses, tout médecin peut être amené à se prononcer sur l'aptitude à conduire en tant que médecin-conseil au sujet d'un de ses patients. Ces dernières années, plusieurs nouvelles recommandations de différentes sociétés médicales ont été publiées en Suisse. Il nous a paru utile de faire une synthèse de ce qui paraît essentiel de savoir avant de rédiger un certificat d'aptitude à la conduite. Medical problems related to car driving are more and more complex and frequent. In the most areas of Switzerland each doctor can be asked to assess the fitness to drive of his patients. Several guidelines from medical societies have been published recently in Switzerland. Therefore it appears to be useful to synthesize the essential knowledge to have before signing fitness-to-drive certificates

Anévrismes de l'artère poplitée: quelle prise en charge en 2013 ? [Popliteal artery aneurysms: management in 2013].

Although rare, popliteal artery aneurysms are the most common peripheral aneurysms and are frequently associated with abdominal aorta aneurysms. They are often bilateral. One third of patients are asymptomatic at diagnosis, with an insidious evolution. Symptomatic patients may present with symptoms of either acute ischemia or chronic ischemia, or rarely compression or rupture. Surgical exclusion of aneurysm followed by venous bypass remains the treatment of choice. Endovascular treatment is an attractive alternative currently reserved for patients at high risk, with good anatomical criteria. Elective treatment before symptoms onset is preferable given the best results in terms of patency and complications. A conservative approach is allowed for small aneurysms without major embolic risk provided careful monitoring by ultrasound.

Quelle attitude lors de la découverte de kystes rénaux [Diagnosis of renal cysts].

Evaluation and management of renal cysts Renal cystic diseases are a heterogeneous group of conditions including heritable, developmental, and acquired disorders. They are united by the presence of microscopic or giant fluid-filled cavities and affect both children and adults. The definitive diagnosis of many of the renal cystic diseases requires clinical, radiological, pathological, and genetic analysis. A precise diagnosis is essential for prognosis, treatment, and future genetic counselling.

Quelle aide peut apporter une psychothérapie ?

La psychothérapie interrogée à partir d'une approche anthropologique de la relation d'aide et de ses enjeux dans une société contemporaine caractérisée par l'individualisme technicisant et concurrentiel.