Les premiers épisodes psychotiques: de l'importance du case management

Depuis 2004, le département de psychiatrie du centre hospitalier universitaire vaudois (CHUV) offre une prise en charge spécifique pour les patients présentant un premier épisode psychotique. La rupture de soins très fréquente, dès la sortie de l'hôpital, le mauvais pronostic à long terme en fonction de la durée de la psychose non traitée et enfin le taux élevé de tentatives de suicide avant une première hospitalisation se sont avérés suffisamment inquiétants et significatifs pour qu'une prise en charge de ce type puisse obtenir un soutien décisif. Dans l'article qui suit, nous nous proposons de décrire le programme Traitement et intervention précoces dans les troubles psychotiques (TIPP) en mettant en lumière la notion centrale de cette offre de soins, à savoir le rôle du case management. Il s'agira de rappeler brièvement les connaissances actuelles sur les psychoses émergentes, particulièrement la perspective plus optimiste que celle naguère réservée à cette forme de trouble psychique. Nous évoquerons également les offres de soins récentes telles qu'elles se déploient dans différents pays pour nous tourner ensuite plus spécifiquement vers notre expérience lausannoise. C'est à cet égard que nous développerons plus en détails le travail essentiel et spécifique du case manager, fil rouge du programme TIPP au long des trois ans qui le composent. La conclusion portera sur les projets de recherche en cours dédiés à cette population de jeunes patients, avec l'espoir que le changement de paradigme évoqué plus haut, un optimisme raisonnable pour le pronostic, puisse lui-même rester une question ouverte à de nouveaux apports scientifiques.

Mapping the transcription start points of the Staphylococcus aureus eap, emp, and vwb promoters reveals a conserved octanucleotide sequence that is essential for expression of these genes.

Mapping the transcription start points of the eap, emp, and vwb promoters revealed a conserved octanucleotide sequence (COS). Deleting this sequence abolished the expression of eap, emp, and vwb. However, electrophoretic mobility shift assays gave no evidence that this sequence was a binding site for SarA or SaeR, known regulators of eap and emp.

A global marine sedimentary response to the end-Permian mass extinction: Examples from southern Turkey and the western United States

The end-Permian mass extinction greatly diminished marine diversity and brought about a whole-scale restructuring of marine ecosystems; these ecosystem changes also profoundly affected the sedimentary record. Data presented here, attained through facies analyses of strata deposited during the immediate aftermath of the end-Permian mass extinction (southern Turkey) and at the close of the Early Triassic (southwestern United States), in combination with a literature review, show that sedimentary systems were profoundly affected by: (1) a reduction in biotic diversity and abundance and (2) long-term environmental fluctuations that resulted from the end-Permian crisis. Lower Triassic strata display widespread microbialite and carbonate seafloor fan development and contain indicators of suppressed infaunal bioturbation such as flat-pebble conglomerates and wrinkle structures (facies considered unusual in post-Cambrian subtidal deposits). Our observations suggest that depositional systems, too, respond to biotic crises, and that certain facies may act as barometers of ecologic and environmental change independent of fossil assemblage analyses. Close investigation of facies changes during other critical times in Earth history may serve as an important tool in interpreting the ecology of metazoans and their environment.

Rajaseutu liikkeessä : Kainuun ja Pielisen Karjalan asukkaiden kontaktit Venäjän Karjalaan kreivin ajasta sarkasotaan (1650-1712)

Väitöskirja, Joensuun yliopisto

Neuronal nicotinic receptors as new targets foramphetamine-induced oxidative damage and neurotoxicity

Amphetamine derivatives such as methamphetamine (METH) and 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) are drugs widely abused in a recreational context. This has led to concern because of the evidence that they are neurotoxic in animal models and cognitive impairments have been described in heavy abusers. The main targets of these drugs are plasmalemmal and vesicular monoamine transporters, leading to reverse transport and increased monoamine efflux to the synapse. As far as neurotoxicity is concerned, increased reactive oxygen species (ROS) production seems to be one of the main causes. Recent research has demonstrated that blockade of 7 nicotinic acetylcholine receptors (nAChR) inhibits METH- and MDMA-induced ROS production in striatal synaptosomes which is dependent on calcium and on NO-synthase activation. Moreover, 7 nAChR antagonists (methyllycaconitine and memantine) attenuated in vivo the neurotoxicity induced by METH and MDMA, and memantine prevented the cognitive impairment induced by these drugs. Radioligand binding experiments demonstrated that both drugs have affinity to 7 and heteromeric nAChR, with MDMA showing lower Ki values, while fluorescence calcium experiments indicated that MDMA behaves as a partial agonist on 7 and as an antagonist on heteromeric nAChR. Sustained Ca increase led to calpain and caspase-3 activation. In addition, modulatory effects of MDMA on 7 and heteromeric nAChR populations have been found.

Control del paciente hipertenso en la clínica odontológica

La hipertensión es la enfermedad cardiovascular más frecuente. En la consulta dental puede detectarse primariamente y referirla para su correcto manejo. La monitorización rutinaria de la presión sanguínea y la valoración de los factores de riesgo con una completa anamnesis puede ayudar a prevenir las emergencias médicas durante el tratamiento dental en pacientes insuficientemente o no tratados y la mortalidad y morbilidad de alteraciones como la insuficiencia renal o el fallo cardíaco, también pueden ser reducidas a través de la detección temprana de dicha alteración.

Yellow and purple nutsedges survey in the southeastern Buenos Aires Province, Argentina

A survey of 79 fields was conducted between December 1993 and January 1994, to determine the distribution and relative importance of species of the genus Cyperus, to justify developing management strategies in the southeastern of Buenos Aires Province, Argentina. Yellow and purple nutsedge were found in 43% and 9% respectively of the surveyed fields. Thirty eight per cent of the surveyed area showed a heavy infestation of yellow nutsedge, and in 90% of cases yellow nutsedge was invading fields cultivated with summer crops and associated with one or more of other seven perennial weeds, mainly bermudagrass.

Generation of biological association networks: A novel strategy to detect new targets in cancer therapy

The aim of this work was to design a novel strategy to detect new targets for anticancer treatments. The rationale was to build Biological Association Networks from differentially expressed genes in drug-resistant cells to identify important nodes within the Networks. These nodes may represent putative targets to attack in cancer therapy, as a way to destabilize the gene network developed by the resistant cells to escape from the drug pressure. As a model we used cells resistant to methotrexate (MTX), an inhibitor of DHFR. Selected node-genes were analyzed at the transcriptional level and from a genotypic point of view. In colon cancer cells, DHFR, the AKR1 family, PKC¿, S100A4, DKK1, and CAV1 were overexpressed while E-cadherin was lost. In breast cancer cells, the UGT1A family was overexpressed, whereas EEF1A1 was overexpressed in pancreatic cells. Interference RNAs directed against these targets sensitized cells towards MTX.