Dépendances [Addiction]

The 2009 news in medicine regarding dependence confirm the bio-psycho-social field of addiction medicine and psychiatry. First a statement is made about the risk of cardiac arythmy in opioid substitution treatments. Then a review of the treatment of C hepatitis shows its importance in an addicted population. In the field of cognitive neuroscience, progress has been made in the knowledge of "craving" and of its endophenotypical components. Electronic medias related disorders are on the border of addiction: a case study is exploring this new domain. At last, recent datas are presented on the relationship between cannabis and psychosis. Les nouveautés en médecine 2009 concernant les dépendances confirment l'étendue du champ bio-psychosocial de la médecine et de la psychiatrie de l'addiction. Tout d'abord un point de situation est fait sur le risque d'arythmie cardiaque dans les traitements de substitution opiacée. Puis une revue de l'actualité du traitement de l'hépatite C dans la toxicodépendance en montre la pertinence. Sur le plan de la recherche plus fondamentale, les neurosciences cognitives progressent dans l'approche de la nature du craving et de ses composantes endophénotypiques. Les troubles liés aux médias électroniques illustrent les frontières de l'addiction : une étude de cas vient en explorer le contenu. Enfin, des données récentes sur les rapports entre cannabis et psychoses sont présentées.

L'hibernation du muscardin Muscardinus avellanarius (Gliridae, Rodentia) en nature: nids, fréquence de réveils et température corporelle

Six muscardins vivant en liberté, munis d'une marque radioactive, ont été étudiés durant un hiver dans leur habitat naturel. L'un d'eux était muni d'un radio-émetteur en position intrapéritonéale permettant de mesurer la température corporelle (Tc) au nid et sur des sites de nourrissage. Tous les nids d'hibernation (n=17) étaient situés sur le sol, dans la litière ou dans un gazon. Un nid d'été a été utilisé occasionnellement durant une période clémente. Entre décembre et avril, les périodes de torpeur de 2 à 27 jours (xmoy= 10.8 j). Les périodes de nomothérmie sans quitter le nid duraient 50 à 210 min (xmoy=105 min). Durant les réveils spontanés, la température corporelle était de 36.7 ± 0.4°C, correspondant à une température corporelle moyenne diurne durant le sommeil (36.8 ± 0.3°C). En captivité, la Tc durant la nuit équivalait à 37.6 ± 0.6°C , tandis que la température en activité, mesurée dans la nature, était de 38.5 ± 0.7°C. Durant la torpeur, la Tc était très proche de la température du sol (∆T < 1°C); quand la température descendait à -3°, la Tc a été maintenue entre -0.4 et -0.8°C. Les nids d'hiver situés en surface du sol et sous une couverture de neige restent durant une grande partie de l'hibernation près de 0 ºC, ce qui est probablement proche de la température à laquelle M. avellanarius présente des dépenses énergétiques minimales.

Hepatosplenic schistosomiasis in field-based studies: a combined clinical and sonographic definition

A combined clinical and sonographic classification of hepatosplenic schistosomiasis mansoni to be used in field-based studies is proposed herein. Seven hundred forty one individuals out of 892 (83%), living in an area endemic for schistosomiasis in Brazil, have been ubmitted to clinical and ultrasound examinations. Based on two stool examinations the overall prevalence for schistosomiasis in this area was 73%. Abdominal palpation was performed with patients in dorsal decubit, during deep breath, by two experienced physicians and a portable ultrasound was used for the evaluation of liver fibrosis, portal collaterals and spleen size. Four groups of individuals were identified using data obtained by abdominal palpation and ultrasound examination: (1) palpable spleen and intense periportal thickening in 9 individuals (1.2%); (2) spleen not palpable and intense periportal thickening in 15 (2%); (3) palpable spleen with light to moderate periportal thickening in 32 (4.3%), and (4) palpable spleen with a normal liver on ultrasound in 30 (4%). The definition of hepatosplenic schistosomiasis in field-based studies as the finding of Schistosoma mansoni eggs in the stools in an individual with splenomegaly is not acceptable anymore. Abdominal ultrasound should be combined with clinical examination to accurately identify hepatosplenics in endemic areas for schistosomiasis.

Navigator-gated free-breathing three-dimensional balanced fast field echo (TrueFISP) coronary magnetic resonance angiography.

RATIONALE AND OBJECTIVES: Recent developments of MR imaging equipment enabled high-quality steady state-free-precession (Balanced FFE, True-FISP) MR-imaging with a substantial 'T2 like' contrast, resulting in a high signal intensity of the blood-pool without the application of exogenous contrast agents. It is hypothesized that Balanced-FFE may be valuable for contrast enhancement in 3D free-breathing coronary MRA. MATERIALS AND METHODS: Navigator-gated free-breathing cardiac triggered coronary MRA was performed in 10 healthy adult subjects and three patients with radiograph defined coronary artery disease using a segmented k-space 3D Balanced FFE imaging sequence. RESULTS: High contrast-to-noise ratio between the blood-pool and the myocardium (29 +/- 8) and long segment visualization of both coronary arteries could be obtained in about 5 minutes during free breathing using the present navigator-gated Balanced-FFE coronary MRA approach. First patient results demonstrated successful display of coronary artery stenoses. CONCLUSION: Balanced FFE offers a potential alternative for endogenous contrast enhancement in navigator-gated free-breathing 3D coronary MRA. The obtained results together with the relatively short scanning time warrant further studies in larger patient collectives.

Immunisation Guidelines for Ireland

This revised report on immunisation guidelines for Ireland has been prepared with the assistance of an active committee from associated disciplines in Paediatrics, Infectious Diseases, General Practice and Public Health. The report itself is designed to be simple and concise and of course does not claim to contain all information on any pharmacological material. It does, however, give the current information and guidelines concerning immunisation. Vaccines are continually evolving and guidelines will obviously change given the nature of these developments. This is a tribute to the pharmaceutical industry who invest so much money in research and development in this particular field. Download document here

What about people in European Regional Science?

The 51st ERSA Conference held in Barcelona in 2011 was one of the largest ever. Here, by examining the characteristics of the conference, this paper identifies the main trends in Regional Science at a moment in which the discipline is renewing its efforts to provide responses in a complex, globalised world in which cities and regions are acquiring greater and greater importance. This paper follows in the tradition of a long list of studies that have examined the nature of the field of Regional Science and draws on a broad array of sources of information: the delegates’ demographic details, the conference program itself, a satisfaction survey conducted among delegates, a quality survey addressed to those chairing the sessions and, finally, a bibliometric database including each author signing a paper presented at the conference. With this information we describe the ERSA delegates: their relative youthfulness; the areas in which women are taking on a more important role; the countries and regions of the world that have the most dominant profile in Regional Science today; the thematic areas that are being driven by professionals as opposed to academics; the relevance of regional economic growth and innovation as trending topics in the field; the growing frequency of co-authorship and, consequently, of scientific collaboration; and, finally, and perhaps most importantly, the continuous enhancement of the quality of the work being undertaken in the discipline. Indeed, following on from this description, the results of the regression analysis conducted show that for ERSA delegates what matters most is quality, and this must be the direction that future conferences should move toward. Ultimately, therefore, ERSA conferences are comprehensive, all-embracing occasions, representing an ideal opportunity for regional scientists to present their work to each other and to network.

Geometric morphometric differences between Panstrongylus geniculatus from field and laboratory

The finding of Panstrongylus geniculatus nymphs inside a house in northeastern Antioquia, Colombia, and the reports related to their increasing presence in homes suggest the need for surveillance methods for monitoring the invasion processes. We analyzed the morphological differences between a wild population and its laboratory descendants, using the techniques of geometric morphometry, with the idea that such differences might parallel those between sylvatic and synanthropic populations. The analyses over five generations showed differences in size but not in shape. Head size and wing size were both reduced from sylvatic to laboratory populations, but the decrease in head size occurred only up to the second generation while the decrease in wing size proceeded up to the fifth generation. In contrast, although a decrease in sexual size dimorphism has been proposed as a marker of colonization in human dwellings, we did not detect any significant loss of dimorphism between sexes of P. geniculatus over the five generations studied. We conclude that size changes may have a physiological origin in response to a change of ecotopes, but more than five generations may be required for the expression of permanent morphological markers of human dwellings colonization.

MP2RAGE, a self bias-field corrected sequence for improved segmentation and T-1-mapping at high field

The large spatial inhomogeneity in transmit B, field (B-1(+)) observable in human MR images at hi h static magnetic fields (B-0) severely impairs image quality. To overcome this effect in brain T-1-weighted images the, MPRAGE sequence was modified to generate two different images at different inversion times MP2RAGE By combining the two images in a novel fashion, it was possible to create T-1-weigthed images where the result image was free of proton density contrast, T-2* contrast, reception bias field, and, to first order transmit field inhomogeneity. MP2RAGE sequence parameters were optimized using Bloch equations to maximize contrast-to-noise ratio per unit of time between brain tissues and minimize the effect of B-1(+) variations through space. Images of high anatomical quality and excellent brain tissue differentiation suitable for applications such as segmentation and voxel-based morphometry were obtained at 3 and 7 T. From such T-1-weighted images, acquired within 12 min, high-resolution 3D T-1 maps were routinely calculated at 7 T with sub-millimeter voxel resolution (0.65-0.85 mm isotropic). T-1 maps were validated in phantom experiments. In humans, the T, values obtained at 7 T were 1.15 +/- 0.06 s for white matter (WM) and 1.92 +/- 0.16 s for grey matter (GM), in good agreement with literature values obtained at lower spatial resolution. At 3 T, where whole-brain acquisitions with 1 mm isotropic voxels were acquired in 8 min the T-1 values obtained (0.81 +/- 0.03 S for WM and 1.35 +/- 0.05 for GM) were once again found to be in very good agreement with values in the literature. (C) 2009 Elsevier Inc. All rights reserved.

Field trials of an improved cost-effective device for detecting peridomestic populations of Triatoma infestans (Hemiptera: Reduviidae) in rural Argentina

An improved device for detecting peridomestic Triatoma infestans consisting of one-liter recycled Tetra Brik milk boxes with a central structure was tested using a matched-pair study design in two rural areas in Argentina. In Olta (La Rioja), the boxes were installed beneath the thatched roofs and on the vertical wooden posts of each peridomestic structure. After a 5-month exposure, at least one of the recovered boxes detected 88% of the 24 T. infestans-positive sites, and 86% of the 7 negative sites by timed manual collections at baseline. In Amamá (Santiago del Estero), the boxes were paired with the best performing prototype tested before (shelter unit). After 3 months, some evidence of infestation was detected in 89% (boxes) and 79% (shelters) of 18-19 sites positive by timed collections, whereas 19% and 16% of 32 negative sites were positive, respectively. Neither device differed significantly in the qualitative or quantitative collection of every sign of infestation. The installation site did not modify significantly the boxes' sampling efficiency in both study areas. As the total cost of each box was half as expensive as each shelter unit, the boxes are thus the most cost-effective and easy-to-use tool for detecting peridomestic T. infestans currently available.

Swiss clinical practice guidelines on field cancerization of the skin.

Actinic keratosis (AK) affects millions of people worldwide, and its prevalence continues to increase. AK lesions are caused by chronic ultraviolet radiation exposure, and the presence of two or more AK lesions along with photodamage should raise the consideration of a diagnosis of field cancerization. Effective treatment of individual lesions as well as field cancerization is essential for good long-term outcomes. The Swiss Registry of Actinic Keratosis Treatment (REAKT) Working Group has developed clinical practice guidelines for the treatment of field cancerization in patients who present with AK. These guidelines are intended to serve as a resource for physicians as to the most appropriate treatment and management of AK and field cancerization based on current evidence and the combined practical experience of the authors. Treatment of AK and field cancerization should be driven by consideration of relevant patient, disease, and treatment factors, and appropriate treatment decisions will differ from patient to patient. Prevention measures and screening recommendations are discussed, and special considerations related to management of immunocompromised patients are provided.

Report of Working Group set up by the Tanaiste in March 2006 to examine the nature and extent of Haemochromatosis in Ireland and to advise her on the action necessary to address the problems caused by Haemochromatosis

It was agreed at a meeting on 15th February, 2006, between Ms Mary Harney, TD, Tanaiste and Minister for Health and Children and Dr Maurice Manning that a Working Group would be set up to examine all of the issues relating to haemochromatosis in Ireland and to advise her on the actions necessary to address these issues. Read the Report (PDF, 709kb)  

Nature et historicité : essai sur la philosophie de Herbert Marcuse

Résumé de Thèse Proche de Horkheimer, d'Adorno ou encore de Benjamin, ce philosophe issu de l'École de Francfort ne manque pas moins d'attirer la curiosité. On a tôt fait de classer Herbert Marcuse (1898-1979) aux oubliettes alors que sa pensée était peu connue, nonobstant une médiatisation très importante qui a dépassé le cadre classique des universités. Ce philosophe allemand atypique dont le nom surgit notamment suite à la publication de L'Homme unidimensionnel fut abondamment lu mais peu systématisé. Repris à tort et à travers, instrumentalisé aux temps des révoltes étudiantes des années 60, il ne lègue pas moins une pensée qui doit apparaître sous une forme nouvelle et prospective. Cette recherche vise prioritairement à l'extraire de ce brouhaha qui l'enveloppa et menaça de le faire disparaître. Cet essai insiste sur un retour à l'exigence scientifique via l'exhumation des textes méconnus du grand public et une insertion indispensable dans l'histoire des penseurs philosophiques. Accéder à la connaissance de ce philosophe passe par un certain nombre de clefs parmi lesquelles le concept de nature. Pour y arriver, cependant, la quête des fondements d'une philosophie dont les sources sont plurielles et inconciliables s'impose comme étape primordiale et pleine de promesses. A la vérité, le peu de systématisation de la pensée marcusienne est en grande partie liée à cette « prolifération » de références auxquelles s'est adonné Marcuse, laissant une mince passerelle susceptible de dégager une architecture globale et cohérente de sa pensée. Certes, la présentation de Marcuse est restée jusque-là prisonnière de l'influence de Hegel, Marx et Freud. L'auteur de cette thèse tente de démontrer que la pensée marcusienne s'oriente à partir de Kant. Attaché à la tradition philosophique germanique de l'Aufklärung, l'oeuvre du philosophe francfortois combat toutes sortes d'irrationalités qui obstruent la voie menant vers un humanisme réel. La nature reste un concept polémique parce qu'il ne saurait se résumer à l'étant. Ni la nature intérieure, ni la nature extérieure ne se limitent à cet horizon dépourvu de subjectivité. Disciple de Heidegger, Marcuse définit la nature à partir du Dasein, un être-là qui est jeté dans l'histoire et qui porte en lui la qualité de l'historicité. Contre la société dite unidimensionnelle postindustrielle qui annonce l'acmé du capitalisme triomphant, les travaux de Marcuse visent un retour à la nature autant qu'ils font de celle-ci un futur. La nature n'est pas seulement ce qu'elle a été, elle est aussi ce qui est à être. En invalidant le consumérisme ambiant, il décrit la publicité marchande comme un acte de négation des vraies valeurs humaines. Ni la superfluité secrétée par le marché, ni les systèmes communiste (le marxisme soviétique et ses sbires) et capitaliste ne sont capables de provoquer l'idéal de l'humain. Le discours marcusien fécondé par la « Théorie Critique » invente le concept de « Grand Refus » adossé à la dialectique hégélienne, obligeant la conscience à veiller sur le réel pour le conduire vers l'émancipation plutôt que vers un « chemin qui ne mène nulle part ». Attachée à la concrétude et la transformation historique héritée de Marx, il réoriente le Dasein heideggérien en lui donnant plus de chair. Nature et historicité, cette réalité duelle se complique parce qu'elle incarne une difficile révolution qui nécessitera davantage d'imagination. Le « Grand Refus » aura besoin d'un allié plus subtile : l'esthétique qui laisse apparaître la Troisième critique kantienne. Au-delà de ce refuge dans l'art, on aura toujours besoin de Marcuse pour mieux comprendre nos sociétés en pleine mutation et pour habiter en conséquence notre monde perfectible.