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Gout attacks are among the fairly frequent situations requiring primary care, the management of which is essential due to the pain and major functional disability that they cause. However, gout disease does not disappear after treatment of the gout attack. Hyperuricemia can lead to many other complications, including rheumatological, metabolic, cardiovascular and renal. The question therefore arises, beyond the treatment of acute gout attacks, of a new look at gout disease and the importance of a uric acid-lowering background treatment. What data are available: hyperuricemia, a simple association or an independent risk factor to be considered as such? [ABSTRACT FROM AUTHOR]

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La définition du goût par l’abbé Charles Batteux (1713-1780) comme « connaissance des règles par le sentiment » est souvent interprétée comme souscrivant à un irrationalisme esthétique, c’est- à-dire comme participant d’une scission entre les domaines cognitif (épistémique) et sensible (esthétique) au XVIIIe siècle. Or cette interprétation pose des problèmes d’ordre textuel et doctrinal à la lecture de l’œuvre. La présente étude tente d’identifier chez Batteux une résistance scolastique au « triomphe de l’ignorant » en matière esthétique et de proposer une description des opérations du goût selon l'abbé.

Gout of the shoulder is a rare entity due to its location, for which the data in the literature do not provide any predictive factors. We report an observation in which a history of neoplasia, as well as the chemotherapy applied to it, may explain this particular location. [ABSTRACT FROM AUTHOR]

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Copyright of Synergies Afrique des Grands Lacs is the property of GERFLINT (Groupe d'Etudes et de Recherches pour le Francais Langue Internationale) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In 1923, the German writer Hermann Hesse began writing an autobiographical account which he called The Curist. During his stay in Baden in 1923, the writer paints an entertaining and humorous portrait of a curist suffering from gout and rheumatism. The narrator alternately mocks and denigrates the patients. But writing the portrait of the other, the patient, also puts into perspective the self-portrait of the writer himself, who is ill and a resident of the place. Thus, it is with a great deal of self-mockery that the narrator mocks his own attitude towards the curists, whom he despised during the first days. This self-experience leads the writer to a splitting of himself in which illness and laughter coexist within the narrative. In this work, Hermann Hesse seeks to express the duality of the world through humour, which allows one to overcome the anxieties of a warring, changing world, but also to have a good time. It is therefore humour as a therapy against human suffering that the author has employed in his story. The satire of the other and the satire of oneself are intended to represent life and the author's dualistic philosophy. [ABSTRACT FROM AUTHOR]

Résumé: Comme dans toutes les maladies chroniques, les patients atteints de rhumatismes inflammatoires chroniques souffrent d'un problème d'adhésion au traitement. L'évaluation des facteurs influençant cette adhésion est une étape cruciale pour élaborer des stratégies pertinentes d'amélioration de la prise en charge. Ainsi, notre étude a permis d'identifier six principaux facteurs qui influencent positivement l'adhésion des patients. À Madagascar, l'inaccessibilité financière aux médicaments ne constitue pas le principal facteur de non-adhésion. Néanmoins, des améliorations des facteurs d'adhésion par des méthodes et des moyens qui ne soient pas dépendants des conditions socio-économiques sont possibles. Les facteurs favorisant l'adhésion thérapeutique identifiés doivent être exploités durant le suivi des patients. As with all chronic diseases, patients with chronic inflammatory rheumatism suffer from a problem with treatment adherence. Assessing the factors influencing this adherence is a crucial step in developing relevant strategies to improve care. Thus, our study made it possible to identify six main factors that positively influence patients' adherence. In Madagascar, financial inaccessibility to drugs is not the main factor for non-adherence. Nevertheless, improvements in membership factors by methods and means which are not dependent on socio-economic conditions are possible. The identified factors favoring adherence to therapy should be exploited during patient monitoring. [ABSTRACT FROM AUTHOR]

This text touches on the consumption of dry or dried products from the point of view of valorization and dessication as a norm of the "good". Dried foods are also those which can circulate in the intra- and extranational migratory contexts thus allowing the commonality of sharing in absence. They also allow us to establish a clear distinction between human foods and demonic foods. And at last, they are the only ones to possess healing powers in the universe of therapeutic rituals linked to alimentation. [ABSTRACT FROM AUTHOR]

Gout and rheumatoid arthritis are two distinct types of inflammatory arthritis with different clinical, biological and radiological features. However, it is sometimes diffcult to distinguish between the two conditions, which may also coexist in the same patient. The aim of this article is to highlight this diffculty in order to avoid diagnostic delays. The association of rheumatoid arthritis and gout is rarely reported. We report two clinical cases illustrating this association in order to avoid any diagnostic delay. [ABSTRACT FROM AUTHOR]

This study reports a case of gouty arthritis in the hip joint in a 57-year-old woman with diabetes and hypertension, with no history of gout, presenting with chronic pain in the right hip. Clinical examination showed obese patient, having painful right limping with lateral hip flexion during walking. Standard radiography objectified osteocondensing formations at the level of the anterior femoral neck. Laboratory tests showed inflammatory syndrome with normal uric acid concentration. Computerised tomography (CT) scan and magnetic resonance imaging (MRI) suggested chondromatosis of the hip. The patient underwent surgical treatment based on complete excision of the friable formation and hip arthrolysis. Bacteria were not isolated during the anatomopathological study which showed gout affecting the hip. The patient received medical treatment based on Colchicine. The patient had complete recovery of flexion, disappearance of limping and satisfactory improvement in hip pain. [ABSTRACT FROM AUTHOR]

Investigations of the main church of the Hurezi Monastery revealed osteological remains belonging to four individuals : three male skeletons (M1, M2 and M3) were discovered when the tomb of archimandrite (abbot) Ioan was opened, together with one female skeleton deposited in a brick crypt found under the sarcophagus of Prince Constantin Brâncoveanu. All three males are old adults, while the female has been determined to be a young adult. The identification of the remains of skeleton M3 was helped by the discovery of a brick containing an inscription with the date of the death of prior Dionisie. For the identification of archimandrite Ioan (the first to hold this rank at Hurezi Monastery, deceased at June 15, 1726, according to the inscription on the grave plate), we were able to use a document belonging to Nicolae Iorga which mentioned that the archimandrite suffered from gout. A palaeopathological analysis of the osteological remains did not yield any bone changes specific to gout. However, the analysis of pathognomonic skeletal markers does not exclude the possibility that the archimandrite did indeed suffer from the disease. On the other hand, the skeletal remains show pathological changes indicative of chronic arthritis, which can, in fact, represent gout. This makes us confident that the skeletal remains found in the tomb M2 do indeed belong to archimandrite Ioan. We mention that the anthropological analyses is accompanied by a medical expertise (see Appendix 2)

Cet article vise à montrer comment les prix littéraires, ces instances de prescription et de consécration, sont au cœur de logiques à la fois culturelles et marchandes, littéraires et économiques. Il interroge les mutations de la désignation institutionnelle de la valeur et du goût à l’aune de plus d’un siècle d’histoire littéraire et éditoriale. Il cherche à montrer comment les industries culturelles, les « médiamorphoses » ou mutation des supports médiatiques, et la poussée spectaculaire via internet des jugements de goûts amateurs ont modifié le statut symbolique et les représentations collectives de l’écrivain et du livre. Il s’articule autour de trois questionnements, qui correspondent à des mutations successives : l’autorité institutionnelle et ses crises, la déterritorialisation du goût et de la valeur, et enfin, l’atomisation d’une légitimité à la carte, qui ne compromet pas cette reconnaissance littéraire, mais au contraire la renforce symboliquement et économiquement.

Gout is a disease caused by an inflammatory response to crystals of sodium monourate, which occurs in people with elevated uric acid levels. There are acute and chronic forms. Acute forms arise as sudden, self-limiting bouts of arthritis (swelling, flushing, pain and heat of a joint), while chronic forms result in the deposition of crystal aggregates in and around the joints, with progressive joint destruction. In addition to joint manifestations, uric gout has renal manifestations (kidney stones and renal insufficiency) and metabolic manifestations (hypertension, elevated triglycerides). Patients are often obese, have high alcohol consumption and insulin resistance. It is a very painful and disabling illness. Gout is more common in men and usually begins in the 40's and 60's. Analytically the patient had uric acid values of 10.2 mg/dL (2.0-7.0 mg/dL) despite being daily medicated with alopurinol 300mg for more than 5 years. It has an abnormality of fasting glycemia and triglycerides of 305 mg/dl. However it maintains consumptions of alcohol and a diet rich in meat, seafood and fats. He did not diet to lose weight and sometimes he does not take the medication (alopurinol). He already shows involvement and destruction of the joints and deformation on the feet and the hand that currently prevent him from fulfilling the necessary safety norms in his profession.

À travers l'entrée privilégiée du « numb taste », un goût qui engourdit les muqueuses de la bouche (et qui est ici provoqué par un fruit : le durian), on aborde la question des rapports humains aux aliments de façon transversale, en liant modes de connaissance, de consommation et de production.Se gardant de toute inflation théorique, le propos s'attache à l'analyse ethnographique méticuleuse du goût et de l'économie générale dans lequel il s'inscrit, entre la Malaisie et Singapour, pour finalement conceptualiser différentes manières de composer et d'éprouver les aliments et les mondes.On liera notamment l'apparition du numb taste à une contrainte agronomique et ontologique que s'imposent les producteurs et les consommateurs de ces deux pays, en laissant tomber des fruits que la rationalité économique la plus évidente leur enjoint pourtant de récolter.

Résumé: Il est intéressant de prendre conscience du nombre de personnes « illustres » qui ont souffert de la goutte, et la recherche historique montre que cela n'a pas concerné seulement l'ère moderne où le diagnostic était posé de façon bien établie. Nous allons successivement nous pencher sur le nombre impressionnant de ces « prestigieux goutteux », pour aborder les hypothèses physiopathologiques progressivement énoncées, et les interprétations épidémiologiques qui sont venues récemment expliquer une partie de ces situations, notamment dans ce qu'on a pu appeler « l'épidémie de goutte anglaise ». It is interestiwho suffered from gout and historical research shows that this has not only affected the modern era where the diagnosis was really well established. We will successively look at the amazing number of these "prestigious gouty people" to address the pathophysiological hypotheses which were set out gradually, and the epidemiological interpretations that have come recently to explain some of these situations, especially in what we could call the "English gout epidemic". [ABSTRACT FROM AUTHOR]

Dans cet article, l’on veut démontrer que le développement de la formule des mémoires romanesques a été catalysé par le travail de Marivaux journaliste. Dans le Cabinet du Philosophe (janvier – juin 1734), dont la publication est contemporaine de La Vie de Marianne, Marivaux observe un changement de goût et le bouleversement de catégories esthétiques du Classicisme. Le style cesse d’être une question d’élocution pour devenir une manière de dire le « je ne sais quoi ». Quand les mots manquent pour dire ce qui est difficile à dire, la combinaison des mots en un récit offre une solution. Ce discours narratif prend pour objet l’être humain qui s’observe lui-même en se scindant en un moi qui observe et un moi qui est observé. Dans les sept feuilles qui composent ce périodique, Marivaux explore plusieurs scénographies, anciennes et nouvelles, pour s’arrêter enfin à une formule discursive où l’énonciateur ne se soucie pas de style et écrit en ignorant par qui il sera lu. Cette solution est proche du roman-mémoires dont Marivaux est en train de produire, au même moment, un des « modèles ».

Competing Interests: L’auteur déclare n’avoir aucun lien d’intérêts.

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Résumé Introduction Les troubles de l’olfaction, du goût, de la mastication et de la déglutition, fréquents chez les patients atteints d’un cancer des voies aérodigestives supérieures (VADS), sont sources de dénutrition. La prise en charge nutritionnelle de ces patients n’est souvent abordée que quantitativement. Mais, même si le recours à une alimentation entérale est nécessaire sur le plan calorique, encourager et maintenir une alimentation orale est primordiale sur le plan social. Objectif Ce référentiel a pour objectif de décrire les soins et la prise en charge alimentaire orale en établissements de santé et au domicile, des patients atteints de cancers des VADS présentant des troubles du goût, de l’odorat et de la déglutition. Méthode Un appel national fut lancé en 2016 pour recruter des professionnels de la santé. Sept conférences téléphoniques, portant sur des axes de travail précis se sont tenues durant l’année 2016. L’étude bibliographique de ce sujet fut discutée et les principales stratégies d’adaptation concernant la prise en charge de ces atteintes furent débattues. Le projet final fut présenté et validé aux 7 e journées des référentiels en soins oncologiques de support, à Nancy, en décembre 2016 et fut publié sur les sites internet de l’Association francophone des soins oncologiques de support (AFSOS) et de la Société francophone nutrition clinique et métabolique (SFNEP). Résultats Les définitions, physiologies et physiopathologies concernant l’odorat, le goût et la déglutition sont exposées. Puis, la prévention ainsi que la prise en charge de chacun de ces troubles sont détaillées. Des axes d’amélioration sont proposés afin de mettre en œuvre, à l’hôpital comme au domicile du patient, des outils luttant contre leur dénutrition. Conclusion Ce travail a abouti à un consensus national sur la gestion et les stratégies d’adaptation des troubles de l’alimentation au domicile, ainsi qu’en centre de soins des patients atteints de cancer ORL. Introduction Malnutrition is particularly related with olfactory, gustatory and swallowing disorders in patients with head and neck cancer. Nutrition is often considered with a therapeutic and quantitative point of view (sum of calories, of proteins, oral supplements, enteral feeding…). However, especially in France, eating is central in the social and familial dynamic and the cancer and its treatments can lead to a dramatic quality of life impairment. Objective Formalize a national consensus about management of olfactory, gustatory and swallowing impairments at home and in care centers. Methods A national call for project was performed to recruit multi-professional volunteers early 2016, anyone was accepted. Seven phone calls with focus groups were set during 2016. Bibliographic study and the main patients coping strategies were sake. Finally, the project was presented and validated in “Guidelines and French Oncology Networks” congress in Nancy, France, in December 2016 and published on the web with either the French National Supportive Care in Cancer Association (AFSOS) and the French National Society for Clinical Nutrition and Metabolism (SFNEP) approbation. Results Definitions, physiological and physiopathological notions about smell, taste and swallowing before, during and after cancer treatments were first recalled. The prevention and management strategies of each trouble were then presented with practical messages: ingredients, cooking technics and plating. Conclusions Finally, this work has led to a national consensus on the management and coping strategies, at home and in care centers, of eating disorders that can be set in parallel with nutrition strategies to improve quality of life impairment. [ABSTRACT FROM AUTHOR]

Résumé L’allopurinol est un médicament hypouricémiant de prescription très facile et usuelle. Or, c’est l’un des principaux médicaments pourvoyeurs de toxidermies graves. L’objectif de notre travail est de souligner l’importance de réserver ce médicament aux cas justifiés, vus les risques de survenue des effets indésirables potentiellement graves. Nous rapportons une série rétrospective de 4 cas de toxidermie à l’allopurinol : syndrome d’hypersensibilité médicamenteuse (DRESS) ( n = 3) et syndrome de Lyell ( n = 1). Le délai moyen d’apparition des signes après la prise médicamenteuse était de 4 semaines. L’imputabilité médicamenteuse était vraisemblable pour les 4 dossiers. Le médicament incriminé était arrêté dans tous les cas et l’évolution était favorable dans deux cas. Cependant, deux décès ont étaient notés dans un contexte de choc septique et de myocardite. Les différentes études montrent qu’il existe une méconnaissance de ce médicament de la part des prescripteurs, en termes de respect des indications et d’ajustement des posologies. Comme tout traitement, son indication doit être réfléchie et se fonder sur les recommandations de bonne pratique. Seul le contrôle du mésusage de l’allopurinol pourrait permettre de réduire de moitié le nombre de cas de toxidermie grave. Allopurinol is the most widely used agent to treat hyperuricemia. However, its misuse can lead to severe toxic dermal reactions. Herein we report four retrospective cases of cutaneous reaction due to allopurinol: drug reaction with eosinophilia and systemic symptoms (DRESS) ( n = 3), and Lyell syndrome ( n = 1). The median time from introduction of the drug to onset of reaction was four weeks. Incrimination of the drug was probable in all 4 cases. Allopurinol was stopped immediately and a favorable outcome was observed in two cases. Two deaths were recorded due to septic shock and myocarditis. Many studies have shown a lack of knowledge concerning the indications and dosage of this agent. Like with all drugs, it should be used in a rational manner and the guidelines should be followed. Control of its misuse is the only way to reduce the rate of severe toxic dermal reactions. [ABSTRACT FROM AUTHOR]

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