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Along with colour, form and texture, the line is one of the constituents of the visual sign. Perhaps the most important considering the amount and diversity of the signifieds that it is able to carry. This is all the more surprising if we know that there are no lines in the Lifeworld: these being pure constructions of our information-processing system. The semiotics of the line is thus deeply rooted in perceptive mechanisms. The constraints thus generated are constituing five distinct degrees zero, each of which can be deliberately violated by rhetorical operations, of which selected examples are shown. We will then identify four types of lines: contour or outline - hollow line - virtual line - locus-line. Additional reflections are finally devoted to the straight line, to the line dimensionality and to the line meaning [ABSTRACT FROM AUTHOR]

Résumé: Les aliments industriels destinés aux nourrissons (4–12 mois) et enfants en bas âge (1–3ans) (en dehors des laits infantiles et des céréales), dénommés aussi aliments pour bébés, se distinguent des aliments industriels non spécifiques conçus pour les adultes et des aliments courants par des critères stricts de composition et de sécurité sanitaire définis par la réglementation française et européenne. Évaluée en France à 89 666 tonnes en 2011 l’offre commerciale pour ces denrées vise à répondre à tous les besoins alimentaires des jeunes enfants : produits laitiers, denrées salées et sucrées, adaptés à l’âge (composition, texture, portions). Les aliments pour bébés ne représentent qu’une part modérée des apports alimentaires des 4–36 mois. Exprimés en pourcentage de l’apport énergétique total, ils constituent en moyenne 7 % de la consommation à 4–5 mois, 28 % à 6–7 mois, 27 % à 8–11 mois, 17 % à 12–17 mois, 11 % à 18–24 mois. Vingt-quatre pour cent des parents n’en donnent jamais à leur enfant, 13 % 1 à 3j/semaine et 63 % 4 à 7j/semaine. Même chez les gros consommateurs, les aliments pour bébés ont peu d’effets sur la qualité nutritionnelle du régime. Cependant, leur emploi retarde et diminue l’utilisation des aliments industriels non spécifiques, ce qui peut contribuer à réduire les risques nutritionnels et toxicologiques liés à la consommation de ces denrées chez les jeunes enfants. Si ces produits sont bien adaptés aux nourrissons et enfants en bas âge, ils doivent rester des aliments de sevrage et de complément à l’alimentation familiale ű faite maison Ƈ. [ABSTRACT FROM AUTHOR]

Abstract: Ferenczi produced elaborations on the regression, the traumatism, the transference and counter transference which question deeply the practice of the cure. His first texts (1908–1912) ask still current clinical questions (on the status of the interpretation and on the place of the body and of the acting in the cures, on the status of the language) and open the way to the elaborations of other psychoanalysts. They will be used as a point of departure of our reflection. [Copyright &y& Elsevier]

Abstract: Introduction: Fabry disease (FD) is an X-linked lysosomal storage disorder caused by mutations in the GLA gene, which leads to a deficient activity of α-galactosidase A. α-galactosidase A activity can be assayed on dried blood spots on filter paper but the original method has been associated with a number of false positive due in great part to quenching of fluorescence. Here, we describe an adaptation of the original fluorimetric method reducing quenching of the fluorescence. Results: A simple and sensitive fluorimetric method has been described for the determination of the α-galactosidase A activity in dried blood spots on filter paper, convenient for screening of FD in at-risk populations. The procedure uses 4-methylumbelliferyl-α-D-galactose, as a synthetic substrate for the enzyme. In this study, protein precipitation was added after incubation both to stop the enzymatic reaction and eliminate interfering proteins. With the novel method the risk of false-positive due to fluorescence quenching was minimized. A cut-off level of 2.1 μmol.h–1.L–1 (control values: 5.6 ± 2.0 μmol.h–1.L–1, mean ± SD) was chosen corresponding to 40 % of median control value. In all 60 hemizygotes males, α-gal A activities were below 1.1 μmol.h–1.L–1 (0.11 ± 0.2 μmol.h–1.L–1). In the 68 heterozygous females, α-gal A activity ranged from 0 to 7.8 μmol.h–1.L–1 (2.2 ± 1.7 μmol.h–1.L–1). Using the improved methodology, one third of the females were not identified using the enzymatic assay, due to significant residual enzyme activity. Conclusion: This improved method for the assay of α-gal A was robust and reduced the number of false-positive results. It can be applied for the screening of at-risk populations. α-galactosidase A enzymatic assay should not be used for screening for FD in women or, if used, should be interpreted cautiously together with the results of genotyping. [Copyright &y& Elsevier]

Résumé Objectif de l'étude L'objectif de ce travail était d'écrire le contrôle local, la survie globale, la survie sans progression et la toxicité de la radiothérapie en conditions stéréotaxiques par CyberKnife® pour les carcinomes hépatocellulaires. Matériels et méthodes Il s'agit d'une étude observationnelle rétrospective et multicentrique, menée au centre Eugène-Marquis à Rennes et au centre hospitalier universitaire Bretonneau à Tours, entre novembre 2010 et décembre 2016. Le traitement a été réalisé en situation de sauvetage, en d'attente d'une transplantation hépatique ou en dernier recours. Résultats Cent trente-six patients ont été consécutivement inclus dans l'étude. Le suivi médian était de 13 mois. La dose médiane totale prescrite était de 45 Gy en trois fractions sur 5 jours. Les taux de survie globale, de survie sans progression et de contrôle local à 1 an et 2 ans étaient respectivement de 79,8 % et 63,5 % ; de 61,3 % et 39,4 % ; de 94,5 % et 91 %. Deux évènements de toxicité aiguë de grade 3 et deux de toxicité tardive de grade 4 ont été rapportés. Sept patients ont souffert d'une hépatite radio-induite classique et 13 d'une hépatite radio-induite non classique. Le stade selon les critères diagnostiques de Barcelone (Barcelona Clinic Liver Cancer [BCLC]), l'indice de performance selon l'Organisation mondiale de la santé et le volume cible prévisionnel étaient corrélés avec la survie globale en analyse de Cox unifactorielle. Conclusion La radiothérapie en conditions stéréotaxiques est un traitement efficace et bien toléré pour les carcinomes hépatocellulaires inopérables ou en attente de transplantation. La toxicité est principalement liée au terrain cirrhotique et implique une sélection des patients et des contraintes de doses strictes sur les organes à risque. Abstract Purpose The purpose of this paper was to describe local control, overall survival, progression-free survival and toxicity of CyberKnife®-based stereotactic body radiation therapy of hepatocellular carcinoma. Material and methods Records of all the patients treated for hepatocellular carcinoma at the Eugene-Marquis cancer centre, Rennes and the Bretonneau hospital, Tours (France), between November 2010 and December 2016, were reviewed. Radiation therapy was performed as a salvage treatment, while awaiting liver transplantation or if no other treatment was possible. Results One hundred and thirty-six patients were consecutively included in the study. The median follow-up was 13 months. Median total dose prescribed, fractionation and overall treatment time were respectively 45 Gy, three fractions and 5 days. Overall survival, progression-free survival and local control rates at 1 year and 2 years were 79.8 % and 63.5 %, 61.3 % and 39.4 %; 94.5 % and 91 %. Two grade 3 acute toxicity events and two grade 4 late toxicity events corresponding to a duodenal ulcer have been reported. Seven patients underwent classic radiation-induced hepatitis and 13 patients showed non-classical radiation-induced hepatitis. Barcelona Clinic Liver Cancer stage, World Health Organisation grade and planning target volume were correlated with overall survival in univariate Cox analysis. Conclusion Stereotactic body radiation therapy is effective and well-tolerated for inoperable hepatocellular carcinoma or as a bridge to liver transplantation. Toxicity is mainly related to cirrhotic background and requires a selection of patients and strict dose constraints. [ABSTRACT FROM AUTHOR]

We propose in this paper a reflection about the relevance and the particularities of the use of therapeutic mediations in the context of clinical practice in consultation-liaison child psychiatry. The accompaniment of a young teenager leading to the creation of a multimedia clip is presented to illustrate the use of therapeutic mediations. This case is then the object of a theoretical and clinical analysis in order to highlight and analyze the psychic processes associated with the use of this mediation. The therapeutic mediation has favored the expression of the patient's desires and anxieties according to a multisensorial dimension – words, melodies, pictures – which supports and catalyzes the primary and secondary symbolization processes. The approach based on therapeutic mediations emphasizes the implementation of a "tailor-made" accompaniment which results in the co-construction of the mediation with the patients. The use of therapeutic mediations in the context of the consultation-liaison child psychiatry appears to be a relevant tool that favors the clinical encounter and the deployment of symbolization processes. [ABSTRACT FROM AUTHOR]

This paper attempts to illustrate the diagnostic, therapeutic and evolutionary aspects of a rare form of an acute neonatal arterial thrombosis. We report the case of a newborn female baby from a pregnancy complicated by gestational diabetes. At birth, we noticed a pallor of the left lower limb, coldness and absence of the distal pulses. Doppler ultrasound showed extensive thrombosis of the left femoral artery. Emergency treatment consisted of thrombolysis by tissue plasminogen activator, after eliminating contraindications. The evolution was rapidly spectacular with repermeabilization of the limb. Heparin was started as a relay treatment. The etiological assessment did not find any risk factor of arterial thrombosis. The dramatic outcome of arterial thrombosis of a limb is amputation. Early diagnosis and management can avoid this situation. [ABSTRACT FROM AUTHOR]

Résumé L’article propose de soulever certaines questions cliniques et épistémologiques posées par la notion de vulnérabilité psychotique, dans le champ de la psychopathologie de l’enfant et de l’adolescent. La vulnérabilité s’est en effet constituée comme un paradigme majeur de la santé mentale contemporaine, suscitant un nombre considérable de recherches sur les facteurs de risque et d’apparition des troubles psychotiques. Les études consacrées au risque de psychose et à sa détection précoce ont marqué, depuis une vingtaine d’années, un tournant dans les modèles de vulnérabilité : les facteurs de vulnérabilité y sont englobés dans la catégorie dite à très haut risque ( ultra-high risk ), voire dans un syndrome de risque de psychose. Mais, concevoir la vulnérabilité comme risque pose plusieurs problèmes : celui d’une spécificité clinique suffisante pour fonder la prédiction, et celui de sa fidélité aux trajectoires développementales singulières. L’article examine ces interrogations à partir de deux exemples aujourd’hui paradigmatiques de la vulnérabilité psychotique : celui des expériences dites quasi-psychotiques chez l’adolescent, et celui du syndrome développemental de microdélétion 22q11.2. Background The goal of this paper is to shed light on specific clinical and epistemological questions raised by the notion of psychotic vulnerability in the field of child and adolescent psychiatry. This notion has nowadays become a major research paradigm and orients numerous studies on risk factors for transition to psychosis. In the last 20 years studies focusing on such risk factors and their early identification have given a new impetus to models of vulnerability: they unify vulnerability factors under the category of ultra-high risk, or even risk syndrome for psychosis. Method A review of the conceptual and historical background framing the notion of vulnerability sheds light on epistemological and clinical ambiguities characterizing its scope and relevance for child and adolescent psychopathology. The paper aims to clarify these questions raised by the vulnerability models by focusing on two paradigm cases of vulnerability to psychosis: psychotic-like experiences in adolescents, and the 22q11.2 microdeletion developmental syndrome. Results The discrepancy between the statistical background of vulnerability factors and a clinical understanding of the vulnerability involves two main difficulties for the clinical scope of these models: the first one relates to a specific vulnerability to psychosis, opposed to a general vulnerability to develop a mental disorder. The second one is the difficulty to grasp, from the perspective of risk models, the clinical and dynamic temporality of the transition toward psychotic symptoms. Discussion These ambiguities raised by the ultra-high risk models call for a psycho-dynamic approach, regarding diagnosis in light of a subjective experience and trajectory, and of the psychic functions and dynamics of a symptom. Such a psycho-dynamic point of view can shed light on a clinical understanding of the vulnerability models. [ABSTRACT FROM AUTHOR]

This paper attempts to illustrate the diagnostic and therapeutic approach of an extremely rare form of esophagogastritis with antenatal disclosure. We report the case of esophagogastritis with antenatal disclosure in a full-term newborn. E.K. was a newborn female baby from a pregnancy carried without complications. At birth, the amniotic fluid was hematic. Examination of the placenta at delivery was normal. The newborn presented hematemesis made of bright red blood, from the first hours of life, without any other associated signs or hemostasis disorder on the biological assessment. The initial therapeutic approach was exclusive parenteral nutrition combined with intravenous proton pump inhibitors. The evolution was marked by the occurrence of melenas and rectorrhagia, complicated by anemia requiring transfusion, without hemodynamic repercussions. An upper gastrointestinal endoscopy was performed on the third day of life and showed moderate erosive œsogastrobulbite. Follow-up was rapidly favorable. In severe neonatal digestive hemorrhages, FOGD plays a key role in the etiological diagnosis and therapeutic management. [ABSTRACT FROM AUTHOR]

Résumé L’analyse interprétative phénoménologique permet au chercheur d’explorer l’expérience de participants, le sens qu’ils donnent à leur expérience et les mécanismes psychologiques sous-jacents. Elle est devenue une des approches les plus reconnues en psychologie et elle est utilisée de façon croissante dans d’autres disciplines. Étant donné cet intérêt croissant apporté à l’IPA, une introduction française est devenue nécessaire. Cet article débute par un rappel général des fondements conceptuels de l’IPA, suivi d’une revue point par point des étapes d’une recherche interprétative phénoménologique. Cet article traite des différents enjeux soulevés par cette approche et conclut avec plusieurs idées de développements à venir. Interpretative phenomenological analysis (IPA) allows researchers to explore the participants’ experiences, the meaning they gave to those experiences, and the underlying psychological processes. IPA recognizes this as involving a double hermeneutic where the participant is trying to make sense of what is happening to them and the researcher is then trying to make sense of the participant's sense making. IPA has now become one of the best known and most widely used qualitative approaches in psychology. After a first decade of development in the United Kingdom, IPA has become an integral part of the research landscape in health psychology and in clinical psychology, and is increasingly being used in other disciplines. It has helped to raise the awareness of a generation of researchers to what qualitative psychology can contribute, and it has enriched the repertoire of methodological practices available for addressing important issues in health. With the growing interest in IPA, we think it is now timely and valuable to offer a French introduction to this approach. The aim of this paper is to introduce to the French-speaking scientific community the foundations of IPA, the different steps involved in a research project and finally the avenues for developing the approach. This paper begins with a general overview of the theoretical foundations of IPA and its place in the scientific landscape in psychology. This is followed by a step-by-step guide to carrying out an IPA study. This begins with an outline of the structure and the content of the data collection process, and the conduct of the interview as well as the alternative frameworks to face-to-face interview and the recommended sample size. We have paid special attention to the analysis cycle and to the communication, assessment and scope of findings. To carry out good IPA requires grasping its core sensibilities. First, IPA has a commitment to an analysis which moves beyond the descriptive to the interpretative, but an interpretative grounded in the close reading of the participant's account. Second, IPA is strongly idiographic, beginning with the close analysis of each case and only then moving to a second level of analysis of the patterning of convergences and divergences within the corpus. Finally, the article discusses various issues arising from the approach and concludes with some thoughts on the issue of language and on future developments like the contribution of single cases, studies of dyadic and group dynamics and the continued involvement of IPA within mixed methods designs. [ABSTRACT FROM AUTHOR]

Résumé Objectif Cet article se donne pour but d’illustrer la spécificité de la valence anale dans le délire paranoïaque (délire de persécution). Il s’agit par-là de discerner la valeur des apports de Karl Abraham sur un critère permettant le diagnostic différentiel entre la paranoïa et la schizophrénie. Méthode Une étude des textes de Freud et de ses premiers continuateurs permet de souligner combien ils ont accordé d’importance à la valence anale dans la paranoïa. Les auteurs s’appuient sur un cas clinique ayant valeur d’exemplarité pour mieux saisir la portée, la place et le rôle de la dimension anale dans le fonctionnement psychique du sujet. L’importance d’une idée de « viol homosexuel » pour le patient dont il est question est mise en exergue. Ses protocoles Rorschach sont étudiés afin de déceler la manière dont la valence anale s’y traduit. Résultats Nous mettons en évidence la fixation anale comme un indicateur primordial dans la paranoïa. Ce critère permet de distinguer la paranoïa de la psychose maniaco-dépressive (bipolarité) et de la schizophrénie. Discussion Cet article ouvre sur la recherche de critères différentiels entre paranoïa et schizophrénie. Il montre aussi combien il importe d’établir une nette distinction entre l’homoérotisme pré-œdipien qui transparaît dans la paranoïa et l’homosexualité proprement dite (œdipienne, génitale). Conclusion La valence anale est un critère pertinent pour distinguer la paranoïa de la schizophrénie, mais aussi de la psychose maniaco-dépressive (bipolarité). Elle peut être mise en évidence notamment grâce à l’analyse de protocoles Rorschach. Objective The very existence of paranoid delusions as distinct from schizophrenic disorders has been widely discussed in recent years. Taking into account these controversies, this paper presents the distinctive features of the anal dimension in paranoid delusion (persecution delusion). The authors aim to show the value of Karl Abraham's theoretical contribution in the form of a criterion which, he claimed, enabled a differential diagnose between paranoia and schizophrenia. The study of Abraham's texts also reveals a criterion enabling a differentiation between manic-depressive psychosis (bipolarity) and paranoia. This paper sets out to test the validity of Abraham's hypothesis by analysing Rorschach protocols of his psychotic patients. Methodology A close reading of several theoretical texts written by Freud and his first followers shows how important they considered the anal dimension in paranoia to be. In what is still considered as his most important text on paranoid psychosis, the Schreber case , Freud shows that the theme of a passive position in sexual intercourse (equivalent to anal penetration) was central to Schreber's view of delusion. Besides Karl Abraham, three of Freud's first supporters, namely Eduard Hitschmann, Johan van Ophuijsen and August Stärke, proposed a detailed description of the anal dimension in some of their paranoid patients. They suggested that, in persecution delusion, an equivalence exists between the paranoid subject's persecutor and the anal object. The authors focus on an exemplary clinical case so as to better understand the scope, the place and the function of anal factors within a paranoid person's psychical functioning. For the patient described, the importance of the idea of a “homosexual rape” is underlined. The subject's whole delusion revolves around it. It is central to his delusional ideas, where the anal dimensions are further illustrated by the results of projective tests. The Rorschach protocols are closely examined so as to discover how they reflect the anal dimension within this paranoid patient's mind. We also note the need to avoid confusion between the purportedly homosexual ideas of psychotic patients (which, in fact, mostly boil down to homoeroticism ) and homosexual orientation properly speaking (which cannot be considered as a disorder). While psychotic homoeroticism stems from a fixation at the anal, pre-œdipal stage, homosexuality constitutes a post-œdipal, genital sexual orientation in its own right. Whereas homosexuality is directed towards an external, self-sufficient object, homoeroticism is directed towards a narcissistic image that remains halfway between the subject and the other. The anal dimension of homoeroticism mostly shows in paranoid patients; it is not an attribute of homosexuality proper. Results The results show that anal fixation is a major indicator for paranoia. This criterion makes it possible to distinguish it from manic-depressive disorder (bipolarity) and from schizophrenia. In manic-depressive disorder, says Karl Abraham, the patient has fully introjected his love-object, whereas in paranoia, the love-object has been incompletely introjected, which creates a strong ambivalence that is reflected by the patient's behaviour. In contrast, in schizophrenia, the love-object has not been constituted as distinct from the patient; the patient remains at a pre-ambivalent stage. Whereas the paranoid patient tries to get rid of the (incompletely introjected) object, the schizophrenic patient feels under threat of being devoured by the love-object. In paranoid patient's Rorschach protocols, the ambivalence towards the object and its anal dimension shows through references to “dirty” animals or objects (“a petrol pit”, “a hog”, “a rat”). These patients harp on the “backside” or the “bottom” of the body. Finally, the male sex is described as aggressive, dangerous, and likened to “a knife”. In schizophrenia, in contrast, Rorschach protocols reflect fears of being devoured, with the mention of “jaws”, “crocodiles” and other such items. Discussion This study encourages future quantitative research on the topic of differential indicators for paranoia and schizophrenia. It tends to prove that paranoid delusions cannot be fully assimilated to schizophrenic disorders. Karl Abraham's differential criteria, based on clinical evidence, could be usefully confronted to Rorschach protocols in greater depth. Conclusion The anal dimension constitutes a valid criterion making it possible to distinguish paranoid disorders from schizophrenia, and also from manic-depressive psychosis (bipolarity). This dimension can be clearly brought to light by analysing psychotic patient's Rorschach protocols. [ABSTRACT FROM AUTHOR]

Résumé Objectifs Cet article présente l’hypothèse, issue du champ de la psychopathologie phénoménologique, de l’hyper-réflexivité schizophrénique, selon laquelle les patients schizophrènes sont pris dans l’expérimentation d’une conscience qui se retrouve contrainte d’interroger des phénomènes qui devraient aller intuitivement de soi. Méthodes La perspective en première personne est une démarche qualitative complétant la lecture, traditionnelle dans le champ de la psychiatrie, en troisième personne – qui consiste en l’attribution depuis une position externe de signes cliniques repérés indépendamment du ressenti exprimé par le patient. Cette perspective en première personne concentre son attention sur l’expérience subjective qu’exprime le sujet. Le discours de plusieurs patients schizophrènes a été recueilli dans le cadre d’un dispositif clinique en utilisant l’échelle EASE ( Examination of Anomalous Self-Experience ). Cette échelle permet l’exploration semi-structurée, d’orientation phénoménologique, d’une série de difficultés révélatrices d’anomalies de l’expérience subjective. Résultats En plus des phénomènes d’hyper-réflexivité, nos analyses mettent en évidence deux grandes caractéristiques de l’être-au-monde schizophrénique. D’abord une problématique du sens commun, qui pose la question de l’intersubjectivité. Ensuite l’existence d’un trouble de l’intercorporéité, les expériences d’hyper-réflexivité schizophrénique s’accompagnant d’une perte du « corps commun ». Discussion L’application d’une perspective en première personne dans la compréhension du vécu des patients schizophrènes, ainsi que l’intérêt porté au phénomène d’hyper-réflexivité, permettent de proposer une vision de la schizophrénie qui n’est plus réduite à une lecture déficitaire de celle-ci (sans nier cette dernière), et qui découvre non pas un affaiblissement, mais une intensification de la conscience. Conclusions La prise en considération de la dimension tacite de l’existence schizophrénique, telle que le suggère la psychopathologie phénoménologique contemporaine, offre de précieuses informations à la pratique clinique et suggère d’importantes perspectives de recherche associant aux designs méthodologiques conventionnels des perspectives novatrices et prometteuses. Objectives This paper considers the hypothesis of schizophrenic hyper reflexivity, which originates in the field of phenomenological psychopathology. It discusses the methodological context enabling these highly subjective manifestations to emerge. Starting from the seminal hypothesis developed by contemporary psychopathology that schizophrenic patients experience a form of consciousness that finds itself forced to question phenomena that should be intuitively self-evident, the idea of the present paper is to complete the usual interpretation of schizophrenia as a deficit by the hypothesis of an excessive functioning of consciousness. Methods The first-person perspective is a qualitative approach completing the third-person interpretation, traditional in the field of psychiatry, which consists in the attribution, from an external position, of clinical signs noted independently from the perceptions expressed by the patient. The first-person perspective focuses on the patient's subjective experience as expressed by that individual. To understand schizophrenia according to this perspective, the narratives of several schizophrenic patients were collected in a clinical setting. We used the EASE scale ( Examination of Anomalous Self-Experience ) for this purpose. This scale offers a phenomenologically-oriented semi-structured exploration of a set of difficulties revealing anomalies in subjective experience, considered as self-awareness disturbances. EASE was developed on the basis of self-descriptions by patients suffering from schizophrenic spectrum disorders. This tool enables the co-construction of a language between patient and clinician, focused on the patient's particular experiences and the unique phenomena he has to cope with. Results Alongside the hyper reflexivity phenomena, the qualitative analyses of the descriptions collected highlight two important features of schizophrenic being-in-the-world. First a common sense issue, which raises the question of inter-subjectivity and the scope for schizophrenic patients to share in a social world. Secondly, the existence of an intercorporeality disturbance, since the schizophrenic hyper reflexivity experiences are accompanied by a loss of the “common body”, the body being the scene where inter-subjectivity is played out. Discussion The use of the EASE scale and the application of the first-person perspective provides a relevant psychotherapeutic approach, both in the process of acknowledgement of the illness (required from the patient as well as from the clinician), and in communication with the families of schizophrenic patients. Conclusions The phenomenological interpretation provided by the application of a first-person perspective in the understanding of schizophrenic patients’ experiences, and the inclusion of hyper reflexivity phenomenon, suggest perspectives on schizophrenia that are no longer reduced to a mere interpretation of deficit (without denying the deficit), showing not a weakening, but a surprising intensification of consciousness. [ABSTRACT FROM AUTHOR]

Résumé Les méthodes d’évaluation du risque et des besoins des personnes contrevenantes ont grandement évolué au cours des 40 dernières années. Elles sont passées d’une évaluation impressionniste basée sur l’expérience clinique à une procédure systématique basée sur la recherche scientifique. Ce n’est toutefois que très récemment que les professionnels ont été en mesure d’avoir accès à un instrument spécifiquement conçu pour évaluer les facteurs de protection contre la récidive et la récidive violente. La Structured Assessment of Protective Factors for Violence Risk (SAPROF) est un outil utilisant le jugement professionnel structuré afin de documenter les éléments protecteurs chez les auteurs d’infractions. Elle comporte 17 domaines protecteurs répartis en trois grandes catégories de facteurs : les facteurs internes, les facteurs liés à la motivation et les facteurs externes. La SAPROF jouit d’un engouement important tant dans les milieux cliniques que chez les chercheurs et constitue un ajout utile au processus clinique d’évaluations des personnes. Risk assessment has greatly changed over the last 40 years. It has moved from a strictly clinical procedure based on clinical judgement, to a structured approach based on scientific literature. While the main goal of first generation structured methods was to estimate the probability of recidivism, we are increasingly interested in knowing more about the reasons that push delinquents to commit new crimes in order to properly intervene and treat the causes at hand. The last generations of instruments now aim to estimate intervention needs and guide rehabilitation practices. Although practitioners largely resort to protective factors to establish avenues to work on, no tool was available until recently to systematically evaluate protective factors. The present article proposes a description of the different measurement and conceptualization issues surrounding protective factors, in addition to addressing the nature of the effect of these factors on recidivism. This paper describes The Structured Assessment of Protective Factors for Violence Risk (SAPROF), a structural professional judgement tool that focus solely on protective factors for violence risk. The SAPROF investigates internal, motivation and external protective factors and has incremental validity over risk assessment instruments. The paper also discusses validation results of the SAPROF, as well as its limitations. The paper finally addresses the crucial question of interfacing risk and protective factors when it comes to estimating the risk for recidivism. [ABSTRACT FROM AUTHOR]

Résumé La radiothérapie en conditions stéréotaxiques des tumeurs hépatiques primitives et secondaires peut être réalisée en complément et/ou comme une alternative à la chirurgie et aux techniques de thermoablation. De nombreuses variantes techniques sont actuellement disponibles, ce qui entraîne une certaine hétérogénéité dans les modalités de délinéation, de prescription de la dose et de détermination des doses de tolérance aux organes à risque. L’objectif de cet article est de permettre une homogénéisation des pratiques afin d’améliorer la qualité et la sécurité de cette technique et de faciliter sa diffusion afin de répondre au principe d’égalité d’accès aux techniques innovantes pour le plus grand nombre de patients. Cette mise au point s’inscrit dans la continuité du guide Recorad, publié en 2016 par la Société française de radiothérapie oncologique (SFRO), en le complétant selon les données récentes de la littérature sur les tumeurs du foie. Stereotactic body radiation therapy for primary and metastatic hepatic malignancies can be performed in association and/or as an alternative to surgery and radiofrequency. The consequences of the great number of techniques available are heterogeneity in contouring, dose prescription and in determination of dose constraints for organs at risk. The objective of this paper is to improve the quality and safety and to help the diffusion of this technique for a majority of patients. In 2016, the French Society of Radiation Oncology (SFRO) published guidelines for external radiotherapy and brachytherapy (“Recorad”). This paper is an update of these recommendations considering recent publications. [ABSTRACT FROM AUTHOR]

Résumé L’article est consacré aux découvertes récentes des sites paléolithiques sur le territoire de l’oasis de Ferghana. Jusqu’à présent, dans cette partie de l’Ouzbékistan, les sites du Paléolithique supérieur restaient inconnus. Les gisements mentionnés dans l’article, préalablement attribués au Paléolithique supérieur, comble une lacune dans la Préhistoire de cette zone. Les industries du Paléolithique supérieur des sites de l’oasis de Tachkent (Kulbulak, Kyzylalma 2, Obirahmat) sont citées ici en tant qu’analogies des sites récemment retrouvés. The paper aims to present recent discoveries of Paleolithic sites in the Ferghana oasis. Until now, the Upper Paleolithic sites were unknown in this part of Uzbekistan. The archaeological deposits mentioned in this paper and preliminarily attributed to the Upper Paleolithic period fill a gap in the Prehistory of this zone. The Upper Paleolithic industries from the Tachkent oasis sites (Kulbulak, Kyzylalma 2, Obirahmat) are here presented as analogies ofrecently discovered sites. [ABSTRACT FROM AUTHOR]

Résumé Objectifs À travers un regard historique, on entend ici confronter le « credo néo-kraepelinien » qui donne à la psychiatrie actuelle, notamment américaine, sa caution épistémologique, au projet initial du père de la psychiatrie moderne. Méthode Pour ce faire, l’article propose de revenir sur le projet kraepelinien d’origine, l’évaluer en propre, le considérer pour lui-même et en sa complexité, en recourant à une analyse précise des grands textes du corpus kraepelinien. C’est autant les textes autobiographiques et méthodologiques que les différentes éditions du Traité qui sont ainsi analysés. Résultats Cette enquête dans les textes de Kraepelin nous invite à prendre en méfiance le soi-disant « empirisme » de la démarche kraepelinienne, et jeter corrélativement un soupçon sur le positionnement « a-théorique » ayant inspiré les tenants du DSM. Loin d’homologuer naïvement l’idée selon laquelle Kraepelin aurait patiemment collectionné les données étiologiques, anatomopathologiques et symptomatologiques de ses cas pour forger innocemment ses entités nosographiques, l’article conduit à réévaluer, dans le fonctionnement de la nosographie kraepelinienne, le poids d’un critère prépondérant, celui de la trajectoire que la pathologie dessine naturellement jusqu’à son état terminal, et qui permet de la déchiffrer sur le seul critère de son évolution. C’est en outre les rapports entre ce critère évolutif et le modèle naturaliste qui sont alors problématisés. Discussion Ressort de cet examen l’idée que l’œuvre du père de la psychiatrie moderne est plus complexe qu’il n’y paraît, et qu’il convient de se déprendre de « l’habillage méthodologique » d’allure empirique dont Kraepelin a enveloppé la construction de sa nosographie. En réalité, entre le projet officiel de Kraepelin et ses réalisations effectives, il y a un hiatus inexplicable : l’ambition méthodologique défendue par Kraepelin et les procédures empiriques qu’il défend n’expliquent pas le mécanisme de composition des entités concrètes qu’il a promues. Conclusions Cela permet de juger l’extraordinaire complexité de l’héritage kraepelinien et de comprendre cette postérité contradictoire, qui fait qu’aujourd’hui, la psychiatrie « néo-kraepelinienne » (se) reconnaît volontiers (dans) le projet kraepelinien mais morcelle les entités découvertes par Kraepelin, lesquelles se trouvent par ailleurs spontanément recaptées par des épistémè fondamentalement concurrentes, mais plus ou moins déconnectées du cadre nosologique naturaliste à travers lequel il les pensait et les identifiait à l’origine. Dans un cas, morcellement des catégories kraepeliniennes et encensement du projet kraepelinien ; dans l’autre, refus de la pensée kraepelinienne, mais fidélité à ses entités. Objectives Adopting a historical perspective, this paper sets out to compare the original project of Emil Kraepelin, the father of modern psychiatry, with the so-called “neo-Kraepelinian credo” which provides contemporary psychiatry, and American psychiatry in particular, with its epistemological framework. Method In order to achieve this objective, the article proposes to re-examine the original Kraepelinian project, to appraise it as such, and to explore its full complexity via an in-depth analysis of the main texts in the Kraepelinian corpus. With this aim in mind, both the autobiographical and the methodological texts, and the successive editions of the Textbook, are analyzed. Results This exploration of the Kraepelinian texts suggests that we should be wary of the supposed “empiricism” of the Kraepelinian approach, and also of the “a-theoretical” positioning of the proponents of the DSM. Far from naively supporting the idea that Kraepelin patiently accumulated etiological, anatomical and symptom-related data from his patients in order to straightforwardly construct his nosography, this article proposes to reassess the weight of a dominant criterion in this nosography – that of a pathological trajectory from the incipient stages to the outcome, enabling the pathology to be interpreted on the sole basis of its evolution. The complex relationships between this evolution criterion and the overall naturalistic Kraepelinian model of mental illness are thus explored. Discussion This exploration shows that the work of the father of modern psychiatry is far more complex than it might seem at first glance. We need to free ourselves from the seemingly empirical methodological trappings of Kraepelin's nosological classification. There is in fact a curious hiatus between Kraepelin's official project and what he actually produced. The methodological approach and the empirical procedures propounded by Kraepelin do not explain the mechanisms enabling the construction of the concrete entities that he supported. Conclusions Thus, the paper enables us to grasp the complexity of the Kraepelinian legacy more fully, and to understand the paradoxical nature of his posterity, whereby contemporary psychiatry readily claims to be “neo-Kraepelinian” but at the same time fragments these Kraepelinian entities. Alongside, these same entities are spontaneously taken up by clearly rival epistemologies that are more or less disconnected from the naturalistic nosological framework that underpinned them. On the one hand, there is a fragmentation of the Kraepelinian categories alongside the exaltation of Kraepelin's project; on the other hand, there is a rejection of Kraepelinian thought alongside faith in his categories. [ABSTRACT FROM AUTHOR]

Résumé Introduction Les infections endodontiques sont caractérisées par leur polymorphisme microbien avec la présence d’agents pathogènes bactériens. Le but de cette étude était de rechercher la présence des levures dans les canaux des dents nécrosées avec ou sans image péri-apicale et d’étudier la sensibilité de celles-ci à une désinfection à l’hypochlorite de sodium à 2,5 %. Méthodologie Des prélèvements endocanalaires réalisés à l’aide de pointes en papier avant et après désinfection à l’hypochlorite de sodium dosée à 2,5 % sur 50 dents monoradiculées chez 38 patients. Ces prélèvements ont été ensemencés dans des boîtes de Pétri contenant du Sabouraud-chloramphénicol (SC). Elles étaient ensuite incubées dans une étuve à 37 °C pendant 48 h. La présence de levures était attestée par des colonies blanchâtres sur tout le pourtour de la pointe en papier et de blastospores à l’examen microscopique dans de l’eau physiologique entre lame et lamelle. L’identification de l’espèce se basait sur ces examens macroscopiques et microscopiques associés au test de blastèse. Résultats Des colonies levuriformes ont été isolées au niveau de 7 dents (14 %) sur les 50. Tous les échantillons positifs étaient prélevés au niveau des dents présentant une nécrose pulpaire ouverte ( p < 0,01). La seule espèce retrouvée était le Candida albicans . La désinfection immédiate du canal à l’hypochlorite de sodium à 2,5 % n’a pas montré une élimination complète des levures. Conclusion Les résultats de cette étude montrent que les canaux des dents nécrosées avec ou sans image apicale peuvent abriter des levures même après désinfection immédiate à l’hypochlorite de sodium à 2,5 %. Summary Introduction Endodontic infections are characterized by their microbial polymorphism with the presence of pathogenic agents such as bacteria. The aim of this study was to investigate the presence of yeast in the root canals of teeth with pulp necrotic with or without apical periodontitis and to study the sensibility of these at disinfection at sodium hypochlorite to 2.5 %. Methods Root canal samples, taken with paper points before and after disinfection with sodium hypochlorite dosed at 2.5 % on 50 single rooted teeth in 38 patients, were seeded in petri dishes containing Sabouraud Chloramphenicol (SC) (Conda Laboratories, Madrid). These stains were incubated in an incubator at 37 °C for 48 hours. The presence of yeast was confirmed by white colonies on the entire circumference of the tip paper. The identification of species was done by macroscopic and microscopic examinations associated with Blastese test. Results The yeast colonies were isolated from 7 teeth (14 %) out of 50. All positive samples were from teeth with an open necrotic pulp ( P < 0.001). The only species found was Candida albicans . Immediate disinfection with sodium hypochlorite at 2.5 % did not show a complete elimination of yeasts. Conclusion The results of this study show that the canal of necrotic teeth with or without apical periodontitis may shelter yeasts even after immediate disinfection with sodium hypochlorite 2.5 %. [ABSTRACT FROM AUTHOR]