Suivi du patient oncologique, garant de la permanence de soi [Follow-up of the cancer patient, maintaining self-identity]

L'individu confronté au diagnostic de cancer subit un bouleversement brutal de ses repères et de ses habitudes. La maladie représente une menace pour son équilibre de vie et sa stabilité sociale. Sa capacité à faire face et à opérer différents remaniements dans sa façon d'être au monde et d'envisager l'avenir est en partie déterminée par ses ressources personnelles. Toutefois, le soutien émotionnel peut également représenter un moyen privilégié de donner du sens à cette expérience singulière qu'est la maladie. La reconstruction narrative dans un cadre soutenant, caractérisé par une écoute bienveillante, offre au patient la possibilité de reconnaître sa souffrance comme partie intégrante de lui-même. Un récit de vie qui intègre la maladie lui permet de se réapproprier son histoire. Cette démarche nécessite de la part du thérapeute une disponibilité psychique et temporelle et la capacité de soutenir le patient dans un processus de liaison à travers les différentes étapes de la maladie. The individual facing the diagnosis of cancer is subjected to abrupt changes with regard to his inner world, his life, habits and social relationships. The patient's capacity to cope, to integrate changes in the way of living and to face the future is determined by his personal resources. However, psychological support may also be an important mean to search for and find sense to the singular experience of the illness. The narrative reconstruction within a supportive setting provides the patient a possibility to recognise his sufferance as an integral part of himself. A life narrative, which integrates the illness, allows the patient to re-appropriate his history again. Such a therapeutic project necessitates from the therapist a psychological and temporal disponibility and a capacity to create links all along the different stages of the disease.

Treatment of cytomegalovirus infection or disease in solid organ transplant recipients with valganciclovir.

Valganciclovir (VGC) has proved efficacious and safe for the prophylaxis against cytomegalovirus (CMV) in high-risk transplant recipients and for the treatment of CMV retinitis in AIDS patients. We used VGC for the treatment of CMV infection (viremia without symptoms) or disease (CMV syndrome or tissue-invasive disease) in kidney, heart, and lung transplant recipients. Fourteen transplant recipients were treated: five for asymptomatic CMV infection and nine for CMV disease. VGC was administered in doses adjusted to renal function for 4 to 12 weeks (induction and maintenance therapy). Clinically, all nine patients with CMV disease responded to treatment. Microbiologically, treatment with VGC turned blood culture negative for CMV within 2 weeks in all patients and was associated with a > or =2 log decrease in blood CMV DNA within 3 weeks in 8 of 8 tested patients. With a follow-up of 6 months (n = 12 patients), asymptomatic recurrent CMV viremia was noted in five cases, and CMV syndrome noted in one case (all cases in the first 2 months after the end of treatment). VGC was clinically well tolerated in all patients; however, laboratory abnormalities occurred in three cases (mild increase in transaminases, thrombocytopenia, and pancytopenia). This preliminary experience strongly suggests that therapy with VGC is effective against CMV in organ transplant recipients; however, the exact duration of therapy remains to be determined: a longer course may be necessary to prevent early recurrence.

Gall inducing arthropods from a seasonally dry tropical forest in Serra do Cipó, Brazil

Highly diverse forms of galling arthropods can be identified in much of southeastern Brazil's vegetation. Three fragments of a Seasonally Dry Tropical Forest (SDTF) located in the southern range of the Espinhaço Mountains were selected for study in the first survey of galling organisms in such tropical vegetation. Investigators found 92 distinct gall morphotypes on several organs of 51 host plant species of 19 families. Cecidomyiidae (Diptera) was the most prolific gall-inducing species, responsible for the largest proportion of galls (77%) observed. Leaves were the most frequently galled plant organ (63%), while the most common gall morphotype was of a spherical shape (30%). The two plant species, Baccharis dracunculifolia (Asteraceae) and Celtis brasiliensis (Cannabaceae), presented the highest number of gall morphtypes, displaying an average of 5 gall morphotypes each. This is the first study of gall-inducing arthropods and their host plant species ever undertaken in a Brazilian SDTF ecosystem. Given the intense human pressure on SDTFs, the high richness of galling arthropods, and implied floral host diversity found in this study indicates the need for an increased effort to catalogue the corresponding flora and fauna, observe their intricate associations and further understand the implications of such rich diversity in these stressed and vulnerable ecosystems.

Effect of Citrus floral extracts on the foraging behavior of the stingless bee Scaptotrigona pectoralis (Dalla Torre)

Effect of Citrus floral extracts on the foraging behavior of the stingless bee Scaptotrigona pectoralis (Dalla Torre). Stingless bees have an important role as pollinators of many wild and cultivated plant species in tropical regions. Little is known, however, about the interaction between floral fragrances and the foraging behavior of meliponine species. Thus we investigated the chemical composition of the extracts of citric (lemon and orange) flowers and their effects on the foraging behavior of the stingless bee Scaptotrigona pectoralis. We found that each type of flower has its own specific blend of major compounds: limonene (62.9%) for lemon flowers, and farnesol (26.5%), (E)-nerolidol (20.8%), and linalool (12.7%) for orange flowers. In the foraging experiments the S. pectoralis workers were able to use the flower extracts to orient to the food source, overlooking plates baited with hexane only. However, orange flower extracts were seemingly more attractive to these worker bees, maybe because of the particular blend present in it. Our results reveal that these fragrances are very attractive to S. pectoralis, so we can infer that within citric orchards they could be important visitors in the study area; however habitat destruction, overuse of pesticides and the competitive override by managed honeybees might have put at risk their populations and thus the ecological services they provide to us.

On the identity of Melipona torrida Friese (Hymenoptera, Apidae)

On the identity of Melipona torrida Friese (Hymenoptera, Apidae). Melipona marginata var. torrida Friese, 1916, described from three workers putatively collected in Costa Rica, never had its identity properly recognized. Since its original description, no additional specimens have ever been collected in Costa Rica. It is argued here that Melipona torrida was based on mislabeled specimens and corresponds to Melipona marginata obscurior Moure, 1971, a form known only from southern Brazil, Argentina and Paraguay. A lectotype is designated for Melipona torrida and notes on the type material of Melipona marginata obscurior are provided. Other known examples of species described from mislabeled specimens in Friese's Zur Bienenfauna von Costa Rica are discussed. It is pointed out that additional names proposed in this work, based on material from Costa Rica, might turn out to correspond to South American taxa. Also, the date of publication of this Friese's paper is discussed.

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The taxonomic identity of Heliconius melpomene f. pyritosa var. fumigata Zikán (Lepidoptera: Nymphalidae)

The taxonomic identity of the butterfly Heliconius melpomene f. pyritosa var. fumigata Zikán, 1937 (Nymphalidae: Heliconiinae) is discussed based on the discovery of the specimen based on which this name was assigned. The specimen is not a variation of Eueides tales surdus Stichel, 1903, as previously stated, but is in fact a variation of H. melpomene f. pyritosa, which is a synonym of Heliconius erato amalfreda Riffarth, 1901.

Mastectomy, body deconstruction, and impact on identity: a qualitative study.

Objectives This qualitative study aims at understanding the consequences of body deconstruction through mastectomy on corporality and identity in women with breast cancer. Design Nineteen women were contacted through the hospital. All had to undergo mastectomy. Some were offered immediate breast reconstruction, others, because of cancer treatments, had no planned reconstruction. A qualitative reflexive methodological background was chosen. Method Women were invited to participate in three semi-structured interviews, one shortly before or after mastectomy, and the other interviews later in their illness courses, after surgery. All interviews were transcribed verbatim. Thematic analysis was performed. The analysis of the first interview of each woman is presented in this article. Results Mastectomy provokes a painful experience of body deconstruction. Even when immediate reconstruction is proposed, contrasted feelings and dissonance are expressed when comparing the former healthy body to the present challenged body entity. Body transformations are accompanied with experiences of mutilation, strangeness, and modify the physical, emotional social, symbolic and relational dimensions of the woman's gendered identity. Although the opportunity of breast reconstruction is seen as a possible recovery of a lost physical symmetry and body integrity, grieving the past body and integrating a new corporality leads to a painful identity crisis. Conclusion With mastectomy, the roots of the woman's identity are challenged, leading to a re-evaluation of her existential values. The consequences of mastectomy transform the woman's corporality and embodiment, and question her identity. Psychological support is discussed in the perspective of our results.

Higher education and national identity : Polish student activism in Russia 1832-1863

Doctoral dissertation, University of Helsinki