Alexithymie et psychopathologie de patients atteints de cancer = Alexithymia and psychopathology of patients with cancer

Résumé Objectif : Décrire l'alexithymie chez des patientsnouvellement diagnostiqués de cancer.Méthode : Les données sociodémographiques, médicales etpsychométriques (HADS, SCL-90, EORTC-QLQ-C30 etTAS-20) ont été enregistrées chez des patients récemment(< 4 mois) pris en charge pour un cancer.Résultats : Chez 70% des 419 patients inclus dans l'étude, unscore qualifiant pour un diagnostic d'alexithymie (TAS > 56)a été observé avec une corrélation négative avec les symptômespsychiatriques, qui par ailleurs ne dépassaient pas lesseuils d'anxiété et de dépression mesurés avec le HADS,et une corrélation positive avec la qualité de vie.Conclusion : La haute prévalence de l'alexithymie, considéréecomme une protection, questionne la nécessité et letype d'éventuelles interventions psycho-oncologiques.Pour citer cette revue : Psycho-Oncol. 5 (2011).

Stomach content analyses of Simulium perflavum Roubaud 1906 (Diptera: Simuliidae) larvae from streams in Central Amazônia, Brazil

Stomach contents of Simulium perflavum Roubaud larvae were analyzed and compared with plankton and periphyton collected in five streams, in Central Amazonia (Manaus and Presidente Figueiredo counties), in Sep./Oct.1996 (dry season) and Feb./Mar. 1997 (rainy season). A total of 1,400 last-instar larvae were dissected; the stomach contents were analyzed using different methods: fresh and after oxidation. A total of 87 taxa (algae, diatoms and rotifers) were found in the stomach contents. In each stream, qualitative samples of plankton and periphyton were collected; these were mounted between slides and cover slips. A total of 94 taxa of plankton and 54 taxa of periphyton were collected. One species of Rotifera was present in the stomach contents, plankton and periphyton. Cluster analysis based on species composition of the organisms present in the stomach contents grouped the streams into two major groups, each belonging to a different drainage area. Correlations based on presence/absence of species of microalgae in the stomach contents, plankton and periphyton indicated significant associations (p<0.05) between stomach contents and plankton and between plankton and periphyton (z test); the Sorensen coefficient and cluster analysis corroborate the same associations.

Age differences in the EEG N2 and P3 components during an interference task

The age-related increase in interference susceptibility has been well documented and largely attributed to a deficit in inhibition. In the present study, event-related potentials were used to investigate EEG correlates of inhibitory processing in an interference "Arrow" task. A specific interest was addressed to theN2 and P3 components that respectively refers to conflict monitoring and to efficiency of inhibition processes (Anguera et al,. 2011). Younger (N=10, Mage=24.6) and older (N=10, Mage=65.5) participants were invited to perform a task consisting in deciding, as fast and accurately as possible, whether an arrow presented on a computer screen points to the left or the right, irrespective of its position on the screen (left, middle or right). Responses were provided by key-presses using the left and right indexes. Three conditions were considered: congruent (arrow pointing to the same direction as that of the side of the screen on which it appears), incongruent (arrow pointing to the opposite direction), and neutral (arrow presented at the center of the screen). A total of 56 trials per conditions were performed. Behaviorally, the results showed that in the incongruent condition the percent of correct responses significantly decreased in both groups. After adjustment with simple RT (additional control task), the increased RTs obtained in the old group were significantly more pronounced in the incongruent condition. With respect to electrophysiological data, results showed that frontal site (Fz), the N2 amplitude was significantly larger for the younger as compared to the older (- 2.55 μV vs. -0.62 μV respectively) whatever the condition. At central site (Cz), the P3 amplitude significantly decreased in the older compared to the younger in the incongruent condition only. Our findings suggest that the increased RTs observed in older participants during the incongruent condition is more specifically linked to late cognitive resources involved in inhibiting prepotent response tendencies rather than associated with earlier stages of treatment dedicated to conflict monitoring.

Electro-cortical modulations and fronto-parietal activity during motor transitions in the elderly

With aging, bimanual movements are performed with increased cerebral activity in frontal and parietal areas. In contrast, motor switching is poorly documented and is expected to engage increasing resources in the elderly. In this study, spontaneous electroencephalographic activity (EEG) was recorded while 39 young participants (YP) and 37 elderly (EP) performed motor transitions from unimanual tapping to symmetric bimanual tapping (= Activation), and opposite (= Inhibition). We measured the delay of switching using the mean and standard deviation of transition time (meanTT and sdTT). Task-related power (TRPow) in alpha frequency band (8-12Hz) was used to measure electro-cortical changes, negative values corresponding to increased cerebral activity. A balance index (BI) was computed between frontal and parietal regions, values non-significantly different from "zero" representing a comparable level of cerebral activity in these regions. The results reveal higher sdTT 1) in EP compared to YP in both transitions, 2) in Activation compared to Inhibition in both groups. TRPow tends to reach greater negative values (p=0.052) in EP compared to YP in both tapping modes and both motor transitions. Furthermore, the results show more negative TRPow 1) in both motor transitions compared to the tapping movements and 2) in frontal region for YP compared to EP during Inhibition only. BI values differ significantly from "zero" for YP in Inhibition only. In conclusion, motor transitions are more variable and tend to be resource-consuming in the elderly. Moreover, the cerebral activity spreading in EP characterized by similar level of activity between frontal and parietal regions suggest reduced capacity to recruit specialized neural mechanisms during motor inhibition.

Psychothérapie en milieu somatique--quelles spécificités [Psychotherapy in the somatic field--what specificities?].

This article illustrates some of the specific aspects of the psychotherapeutic approach with medically ill patients. Our considerations are based on our daily work in CL Psychiatry and refer to the psychodynamic model, rooted in Freudian's thought. Characteristics are the setting, as well as the relationship with the patient and the interactions with the physicians as the "emergence" of the suffering body within the therapy. We therefore adopt specific approaches such as the work with the Auxiliary Ego and the narrative reconstruction. This paper illustrates our experiences applying the mentioned tools with patients suffering from chronic pain and cancer.

Validation of Logistic Regression Models for Landslide Susceptibility Maps

A wide range of numerical models and tools have been developed over the last decades to support the decision making process in environmental applications, ranging from physical models to a variety of statistically-based methods. In this study, a landslide susceptibility map of a part of Three Gorges Reservoir region of China was produced, employing binary logistic regression analyses. The available information includes the digital elevation model of the region, geological map and different GIS layers including land cover data obtained from satellite imagery. The landslides were observed and documented during the field studies. The validation analysis is exploited to investigate the quality of mapping.

Psychodynamic psychotherapy in newly diagnosed cancer patients: a randomized controlled trial

Aims: (i) To describe the prevalence and profile of newly diagnosed cancer patients motivated for psychotherapy and (ii) To evaluate its effectiveness.Methods: Between 2006 and 2009, every new patient of the Oncology Service of the University Hospital Lausanne was informed of the opportunity to benefit from psychotherapeutic support. Patients were randomly assigned to an immediate or delayed (4 month waiting list) psychodynamicoriented psychotherapeutic intervention, formalized as short intervention (1-4 sessions) or brief psychotherapy (16 sessions). Patients with no interest were asked to participate in an observational group. Socio-demographic and medical data, anxiety and depression (HADS, SCL-90), alexithymia (TAS) and quality of life were evaluated for all groups at baseline and 1, 4, 8 and 12-months follow-up. Results: Of 1973 patients approached, 1024 were excluded, mainly because of organisational reasons (living too far away, interfering treatments, etc.), ageN75 years, life expectancyb1 year or language difficulties. One fourth (N=530) refused to participate and 229 patients accepted to be followed in the observational group. Patients interested in psychological support (N=190, 94 in immediate and 96 in delayed intervention) were younger, predominantly female and symptomatic (higher depression and anxiety scores); 56% engaged in 1-4 and 44% in 16 sessions.Conclusions: The naturalistic design of this study revealed relevant questions regarding (i) the design of such studies (untargeted intervention, choice of measurement, etc.), (ii) the type of interventions (pro-active approaches of men, those unable to speak the language or who can not leave home) and (iii) the profile of patients accepting support. A complete analysis will be presented at the congress.Keywords: Psychotherapy, psycho-oncology, cancer, methodology, interventions

Don de rein altruiste: enjeux psychologiques [Altruistic kidney deviation: psychological challenges].

Altruistic kidney donation challenges ethical principles, questions the anthropological meaning of donation and is associated with important psychological aspects. Obtaining free and informed consent is essential and requires a depth evaluation by a psychologist or a psychiatrist in order to identify the motivations which stimulate the desire of donation. By means of a psychodynamic understanding of a clinical case, we illustrate the complexity of the evaluation of consent and discuss the psychological issues associated with altruistic kidney donation.

La primacia de la pràctica en la filosofia de l’últim Wittgenstein

Amb aquest treball ens proposem bàsicament fer una lectura de De la certesa, el veritablement darrer text de Ludvig Wittgenstein atès que les seves últimesentrades van ser escrites tot just dos dies abans de morir. Avui comença a ser acceptada la idea que Wittgenstein no va escriure dues sinó tres obres majors. El relat estàndard que parla de dos Wittgensteins (el del Tractatus i el de les Investigacions) va essent qüestionat o si més no matisat, a mesura que va creixent l’interès pels últims textos de Wittgenstein i en particular pel text que ens ocupa. El nostre treball de recerca serà doncs, una lectura de De la certesa, convençuts com estem de la seva rellevància, tant pel què fa a la comprensióde la pròpia filosofia de Wittgenstein i la seva evolució, com pel què fa a algunes qüestions centrals en el debat de l’epistemologia contemporània. Ensproposem dir alguna cosa sobre l’obra en si mateixa, el seu lloc en el corpuswittgensteinià, i sobre la rellevància dels seus plantejaments en el debat actual al voltant de l’escepticisme i el relativisme

Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study.

The CIAO Study ("Complicated Intra-Abdominal infection Observational" Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012).Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.2,152 patients with a mean age of 53.8 years (range: 4-98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified.The overall mortality rate was 7.5% (163/2.152).According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission.Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe.

La lutte des races : recherches sociologiques / par M. Louis Gumplowicz,... ; trad. de M. Charles Baye

Collection : Collection d'auteurs étrangers contemporains ; 5

Experience and intermediate-term results using the Contegra heterograft for right ventricular outflow reconstruction in adults.

OBJECTIVES: The Contegra bioprosthesis (valved heterologous bovine jugular vein) is used for reconstruction of the right ventricular outflow tract (RVOT) in congenital heart malformations and pulmonary valve replacement in different settings. Compared to pulmonary homografts, the Contegra conduit is readily available 'on the shelf'. So far, its use was mainly described in children. The aim of this study is to evaluate the feasibility and the outcome of Contegra graft implantation in the adult. METHODS: Between November 1999 and December 2007, a total of 32 Contegra grafts were implanted in 31 patients (24 men and 7 women), with a mean age of 35.7+/-10.5 years (range 18-54 years). All operations have been completed through median sternotomy with cardiopulmonary bypass. Indications included: Ross procedure for aortic valve disease (n=22); re-operation of corrected Fallot-tetralogy (n=5); isolated pulmonary valve disease (n=2); re-operation of double outlet right ventricle (DORV) (n=1); pulmonary stenosis in congenital dilated cardiomyopathy (DCM) (n=1). Conduit sizes included 22 mm (n=31), 20 mm (n=1). RESULTS: There was no hospital mortality and no valved conduit related early morbidity. In the median follow-up of 38 months (range 1-99 months) of 28 patients there was one late death, not conduit related (total mortality 3.6%). Re-operation for symptomatic graft stenosis was realised in two patients, 7 and 16 months after primo-implantation, corresponding to graft related late morbidity of 7.1%. CONCLUSIONS: In this small review of 32 operations using the Contegra graft for RVOT reconstruction in adult cardiac surgery for different indications, we observed good postoperative mid-term results concerning conduit function. Mean transpulmonary pressure gradients remain low (13.3+/-6.6 mmHg postoperative, 14.5+/-7.9 mmHg at follow-up). The use of the Contegra graft seems to be a good alternative to the homograft with low operative mortality and morbidity. Long-term outcome data are not available and further investigations must be performed to evaluate results.