L'observation du "jeu triade Lausanne" et son utilisation thérapeutique

Dans le cadre d'une consultation thérapeutique où nous recevons des familles cliniques et non-cliniques, nous observons les interactions triadiques père-mère-bébé avec des nourrissons de 8 semaines à 1 an, dans une situation de jeu semi-standardisé, le jeu triade Lausanne. Cette situation, révélatrice des modes de communication dans la famille, constitue un outil clinique d'évaluation. Après avoir décrit ce jeu à trois et notre analyse de la situation, nous présentons un exemple d'observation d'une famille où la mère a été hospitalisée, avec son enfant alors âgé de 6 mois, pour une psychose du post-partum. Nous décrivons comment la consultante, par les moyens non-verbaux, encadre cette famille pour organiser le jeu à trois. Cette expérience positive va donner des indications précieuses pour la suite du traitement.

The changing preference of T and B cells for partners as T-dependent antibody responses develop.

Recirculating virgin CD4+ T cells spend their life migrating between the T zones of secondary lymphoid tissues where they screen the surface of interdigitating dendritic cells. T-cell priming starts when processed peptides or superantigen associated with class II MHC molecules are recognised. Those primed T cells that remain within the lymphoid tissue move to the outer T zone, where they interact with B cells that have taken up and processed antigen. Cognate interaction between these cells initiates immunoglobulin (Ig) class switch-recombination and proliferation of both B and T cells; much of this growth occurs outside the T zones B cells migrate to follicles, where they form germinal centres, and to extrafollicular sites of B-cell growth, where they differentiate into mainly short-lived plasma cells. T cells do not move to the extrafollicular foci, but to the follicles; there they proliferate and are subsequently involved in the selection of B cells that have mutated their Ig variable-region genes. During primary antibody responses T-cell proliferation in follicles produces many times the peak number of T cells found in that site: a substantial proportion of the CD4+ memory T-cell pool may originate from growth in follicles.

Estudio de los pacientes con diagnóstico de bronquiectasias, que siguen control en el servicio de neumología del Hospital Son Llátzer. Palma de Mallorca

L'objectiu de l'estudi ha estat conèixer l'etiologia,característiques clíniques, tractament i evolució dels pacients diagnosticats de bronquiectàsies i controlats en el Servei de Pneumologia de l'H Llàtzer. Des de gener 2003 fins juny 2009 s'identifiquen 48 pacients, amb edat mitjana de 60 a. i predomini de dones. L'etiologia més freqüent va ser la post-infecciosa i P. aeruginosa el germen més habitual. El patró ventilatori dominant va ser el obstructiu. Després de 45 mesos de seguiment no es va apreciar deteriorament de la funció pulmonar, probablement relacionat amb el tractament antibiòtic i antiinflamatori en la colonització / infecció bronquial crònica. Paraules clau: bronquiectàsies, Pseudomona aeruginosa, Tomografia computada (TC) de tòrax.

Prisonnier de son petit studio...

Le suivi intensif dans le milieu (SIM) est une équipe de psychiatrie mobile pluridisciplinaire qui propose des soins au sein de la communauté. Après avoir décrit le modèle d'intervention, cet article illustre par un exemple clinique en quoi ce type de suivi facilite le processus de rétablissement de personnes considérées comme réfractaires aux soins.

Feeding preference of the sand flies Lutzomyia umbratilis and L. spathotrichia (diptera: Psychodidae, Phlebotominae) in an urban forest patch in the city of Manaus, Amazonas, Brazil

Precipitin tests were performed on blood meals of 199 sand flies (161 Lutzomyia umbratilis, 34 L. spathotrichia, two Lutzomyia of group shannoni, one L. anduzei) in a non-flooded upland forest on the Campus of the Universidade Federal do Amazonas. This is the second largest forest fragment in an urban setting in Brazil. Results on L. umbratilis, which is considered to be the principal leishmaniasis vector in this region, indicated rodents as its predominant blood source in contrast to previous reports in which blood meal analysis indicated that this species fed principally on Xenarthra (particularly sloths)

Habitat preference of freshwater snails in relation to environmental factors and the presence of the competitor snail Melanoides tuberculatus (Müller, 1774)

Our objective is to evaluate the habitat preference of freshwater snails in relation to environmental factors and the presence of the competitor snail Melanoides tuberculatus. In the first phase, snails was collected at 12 sites. This sampling sites presented a degree of organic input. In the second phase 33 sampling sites were chosen, covering a variety of lotic and lentic environments. The snail species found at Guapimirim, state of Rio de Janeiro, displayed a marked habitat preference, specially in relation to the physical characteristics of each environment. Other limiting factors for snail distribution at the studied lotic environments were the water current velocity and the amount of organic matter, mainly to Physa marmorata, M. tuberculatus, and Biomphalaria tenagophila. The absence of interactions between M. tuberculatus and another snails could be associated to the distinct spatial distribution of those species and the instability of habitats. This later factor may favor the coexistence of M. tuberculatus with B. glabrata by reduction of population density. In areas of schistosomiasis transmission some habitat modification may add to the instability of the environment, which would make room for the coexistence of M. tuberculatus and Biomphalaria spp. In this way, some of the usual measures for the control of snail hosts would prevent the extinction of populations of Biomphalaria spp. by M. tuberculatus in particular habitats.