Search

Although lithium is widely used in current practice to treat bipolar disorder (BD) and treatment-resistant major depressive disorder (MDD) among older adults, little is known about its efficacy and tolerability in this population, which is generally excluded from randomized clinical trials. The objective of this study was to evaluate the efficacy and tolerability of long-term use of lithium among older adults with BD and MDD.Data from the Cohort of individuals with Schizophrenia and mood disorders Aged 55 years or more (CSA) were used. Two groups of patients with BD and MDD were compared: those who were currently receiving lithium versus those who were not. The effects of lithium on psychiatric (i.e., depressive symptoms severity, perceived clinical severity, rates of psychiatric admissions in the past-year), geriatric (overall and cognitive functioning) and physical outcomes (i.e., rates of non-psychiatric medical comorbidities and general hospital admissions in the past-year) were evaluated. All analyses were adjusted for age, sex, duration of disorder, diagnosis, smoking status, alcohol use, and use of antipsychotics, antiepileptics or antidepressants.Among the 281 older participants with BD or MDD, 15.7% were taking lithium for a mean duration of 12.5(SD = 11.6) years. Lithium use was associated with lower intensity of depressive symptoms, reduced perceived clinical global severity and lower benzodiazepine use (all p 0.05), without being linked to greater rates of medical comorbidities, except for hypothyroidism.Data were cross-sectional and data on lifetime history of psychotropic medications was not assessed.Our results suggest that long-term lithium use may be efficient and relatively well-tolerated in older adults with BD or treatment-resistant MDD.

Resume Objectif Les objectifs de cette etude etaient de decrire la consommation de medicaments chez des femmes enceintes en France dans le contexte de maladies chroniques ou aigues et d’analyser les liens entre leurs caracteristiques sociodemographiques, leurs modes de vie et la consommation de medicaments. Methodes Etude descriptive transversale menee aupres de femmes enceintes a partir d’un questionnaire electronique. Une regression logistique a permis de decrire les facteurs maternels associes a la consommation de medicaments. Resultats Un total de 374 femmes a repondu au questionnaire. Elles etaient respectivement 75,1 % ( n = 280) et 12,6 % ( n = 47) a avoir pris au moins un medicament pendant la grossesse en raison de maladies aigues ou chroniques respectivement. Un total de 68,9 % ( n = 258) des femmes interrogees ont deliberement evite de prendre des medicaments en vente libre lorsqu’elles etaient enceintes. Les femmes ne prenant pas d’acide folique sont moins nombreuses a consommer des medicaments 78,9 %, que celles qui en prenaient, 89,5 %, OR = 0,44 [0,24 ; 0,79]. Conclusion Cette etude montre que plus de huit femmes francaises sur dix ont pris des medicaments pendant leur grossesse, et notamment des antalgiques. Les caracteristiques sociodemographiques ne semblent pas avoir d’impact sur la consommation de medicaments durant la grossesse.

Introduction La cohorte TELOCAP a permis d’evaluer l’influence de divers parametres immunologiques dans le cancer bronchique non a petites cellules (CBNPC). Nous presentons ici l’influence de la lymphopenie T CD4 + sanguine dans cette cohorte. Methodes Ont ete inclus les patients diagnostiques d’un CBNPC, de stade clinique I a IV, traites au CHU de Besancon et a l’hopital europeen Georges-Pompidou [1] . La lymphopenie T CD4 + la lymphopenie T CD8 + dans le sang circulant, etaient respectivement definies comme un nombre absolu de lymphocytes (ALC) [2] . Le critere principal de jugement etait la survie globale. Resultats Au total, 186 patients ont ete inclus de 2010 a 2014. Les analyses univariees ont montre que la lymphopenie T CD4 + etait correlee a une plus faible survie globale (HR 1,616 [IC95 % = 1,107 ; 2,358] p = 0,0127). En revanche, aucune association n’a ete trouvee avec la lymphopenie T CD8+. En analyse multivariee, le statut de performance ≥ 2 (HR : 2,191 [IC95 % = 1,413 ; 3,396] p = 0,0005), le stade metastatique (HR : 2,558 [IC95 % = 1,722 ; 3,802] p . Conclusion Dans la presente etude, nous avons identifie la lymphopenie T CD4 + comme un facteur pronostique independant, pejoratif, pour la survie globale dans le CPNPC chez les patients atteints de CBNPC localise.

International audience; The presence of a Localized Surface Plasmon Resonance in doped semiconductor nanostructures opens a new field for plasmonics and metasurfaces. Semiconductor nanostructures can be easily processed, have weak dissipation losses, and the plasmon resonance can be tuned from the mid- to the near-infrared spectral range by changing the dopant concentration (in complement to the constituent material, the size and shape of the nanostructure). We present in this paper an extension of the Green Dyadic Method applied to the case of doped silicon nanostructures of arbitrary shape on a planar silica substrate. The method is used to compute both far- and near-field optical properties, such as the extinction efficiency and the electromagnetic near-field intensity inside and around any doped silicon nanostructure, respectively. This theoretical approach provides an important tool for active dopant characterization in doped semiconductor nanostructures, for near-field imaging of complex nanoantennas produced by electron beam lithography, and for the definition of doped semiconductor-based metasurfaces.

Summary Methods A questionnaire (146 questions) devised by ASSPRO Scientifique (Association de prevention du risque operatoire – Association for the prevention of surgical risk) and covering the professional and personal indicators likely to be involved in stress was used to assess the level of satisfaction or dissatisfaction of physicians and the level of stress. The collected data were analysed using frequency distribution tables and cross tabulations. Results Of the completed questionnaires returned by 1272 physicians (21.9% of the sampled physicians), 1204 questionnaires could be used. Of the total sample, 85.5% was male, between 35 and 64 years old (92.8%); they were anaesthetists (29.6%), orthopaedists (29.4%) or obstetrician gynaecologists (12.8%) attending a single workplace (67.9%) in sector 2 (64%). More than one quarter of these physicians reported feelings of exhaustion after work and one quarter of them had a fear of the workload ahead. Overall, the mean level of happiness (on a scale from 0 to 10) was quite high (6.7) and the mean stress level (graded from 0 to 10) was 5.9 (above or equal to 8 in 29.8%). The links between the stress level and the behaviour or the frame of mind at work were especially clear and significant for the following factors (stress level on a scale from 0 to 10): fear of the workload ahead (8.3), feeling of exhaustion (7.6), inability to ‘switch off’ (7.5) or to distance oneself from the difficult times of the day (7.3), sleeping disturbances (7.3), back pain (6.9) and headaches (6.9), which factors seem to be strong indicators of an advanced state of stress.

A MnO/NaOH based three-step thermochemical water splitting cycle was modified to improve the hydrolysis of α-NaMnO 2 (sodium manganate) and to recover Mn(III) oxides for the high-temperature reduction step. Sodium manganate forms in the reaction of NaOH with MnO that releases hydrogen. The hydrolysis of α-NaMnO 2 to manganese oxides and NaOH is incomplete even with a large excess of water and more than 10% sodium cannot be removed prior to the high-temperature reduction step. When mixed oxides of manganese with iron were used in the cycle, the NaOH recovery in the hydrolysis step improved from about 10% to 35% at NaOH concentrations above 1M. Only 60% sodium was removed at 0.5M from the mixed oxides whereas more than 80% can be recovered at the same NaOH concentration when only manganese oxides are used. A 10:1 Mn/Fe sample was cycled through all steps three times to confirm that multiple cycles are possible. The high-temperature reduction was carried out for 5h at 1773 K under vacuum and the conversion was about 65% after the 3rd cycle. Since sodium carryover into the high-temperature reduction cannot be avoided, even with the energy intensive hydrolysis step, a modified two-step cycle without low-temperature sodium recovery is proposed where α-NaMnO 2 is reduced directly to MnO at 1773 K under vacuum. On a laboratory scale, about 60% of the sodium that volatilized at the high temperatures was trapped with a water-cooled cold finger and conversions were stable at about 35% after three completed cycles.

Resume Les troubles bipolaires sont la sixieme cause de handicap a travers le monde et les patients sont plus de la moitie de leur temps symptomatiques, malgre les traitements medicamenteux. Deux etudes controlees ont montre l’efficacite des groupes de psychoeducation sur le pronostic des troubles bipolaires en termes de rechute et de rehospitalisation, mais il existe peu de donnees sur les mecanismes d’efficacite de cette prise en charge. L’objectif de cette etude est d’evaluer les effets de la psychoeducation sur le rythme de vie et la reponse aux stress mineurs. La population etudiee est constituee de 60 patients bipolaires candidats a des seances de psychoeducation, randomises en deux groupes : un groupe « therapie immediate » (« IT » : n = 30) et un groupe « liste d’attente » (« LA » : n = 30). Apres un entretien diagnostic structure, les patients sont evalues en ambulatoire a deux reprises pendant une semaine a l’aide d’un agenda electronique utilisant la methode d’echantillonnage des experiences (ESM). Cette technique permet le recueil d’informations prospectives et de mesurer la maniere dont la psychoeducation peut modifier les comportements specifiques, les experiences ou les facteurs de risque. L’enregistrement par l’ESM est realise avant et apres participation au groupe de psychoeducation pour le groupe « IT » et pendant les memes periodes pour le groupe « LA ». Les donnees seront analysees a l’aide du Modele hierarchique lineaire et les resultats devraient permettre de mieux comprendre comment la psychoeducation modifie le quotidien des patients bipolaires.

New sedimentological and biostratigraphical data have been obtained from unconformable series (Tasraft Formation) on some intruded anticlines located in the Central High Atlas of Morocco. Our results lead us to contest the previous Middle Jurassic to Middle Cretaceous ages only based on lithostratigraphic similarities. The Tasraft Formation proves to be a syntectonic series characterized by detritic fluvial sediments followed by lacustrine and lagoonal-marine limestones. Ostracods and charophytes found in different levels of the unconformable series indicate Thanetian ages. According to these new stratigraphical data, we can conclude that the main structures of the axial part of the High Atlas (folds, cleavage and exhumation of gabbroic bodies) were settled before the Late Paleocene. Moreover, the occurrence of Paleocene nonmarine beds in the axis of the High Atlas Belt implicates to modify the paleogeographic boundaries of the Atlantic transgressions in the beginning of the Tertiary.

(1) Clinique du Château, 11 bis, rue de la Porte Jaune, 92380 Garches. Les thymoregulateurs ont considerablement ameliore le pronostic du trouble bipolaire, en limitant le nombre de recidives et en reduisant le risque de complications somatiques, psychiatriques, psychologiques et sociales. Neanmoins, un pourcentage important de patients continue a presenter des fluctuations thymiques du fait d’une mauvaise observance therapeutique, de la persistance de facteurs declenchants, precipitants ou d’entretien du trouble, du non-respect des regles d’hygiene de vie, mais aussi du fait du genie evolutif de certaines formes graves. Gitlin et al. (3) montrent que 37 % des patients bipolaires ont une recidive la premiere annee, 60 % la seconde et 73 % apres cinq ans. La persistance de symptomes residuels entre les episodes est retrouvee dans un tiers des cas et donne a ce trouble une dimension chronique (4). Pour Johnson et Miller, la normalisation thymique sera trois fois plus longue a obtenir chez des patients hospitalises s’ils ont ete confrontes a un evenement penible de vie (5). Les mesures psychoeducatives, dont le role a longtemps ete sous-evalue dans les troubles bipolaires, font partie avec les therapies cognitivo-comportementales, des traitements psychologiques les mieux documentes et pour lesquels il existe un niveau de preuve d’efficacite eleve. Les benefices de cette approche complementaire sont multiples : reconnaissance precoce des symptomes qui annoncent une recidive, amelioration de la qualite de l’observance, meilleure gestion de la vie sociale, professionnelle et affective, controle des facteurs declenchants et precipitants, respect des regles d’hygiene de vie... Les etudes publiees confirment ces donnees et rapportent une diminution du nombre de recidives et de rechutes, une diminution de la duree d’hospitalisation, un meilleur equilibre de la vie familiale, une amelioration de la qualite de vie. DEFINITION ET OBJECTIFS DES MESURES PSYCHO-EDUCATIVES

Resume Introduction. – La duree d'hospitalisation apres resection colorectale est de l'ordre de 15 jours en France, alors que certaines equipes ont publie des durees de deux a cinq jours. L'objectif de ce travail a ete d'obtenir une duree de sejour postoperatoire inferieure a sept jours. Patients et methodes. – L'etude a porte sur 61 patients ayant eu une resection colorectale par laparotomie : 16 hemicolectomies droites, neuf gauches, 15 sigmoidectomies et 21 resections anterieures. L'intervention a ete pratiquee par une incision mediane depassant l'ombilic dans 13 cas, sous-ombilicale dans 22 cas, elective dans 26 cas (transverse droite dans 16 cas et iliaque gauche dans dix cas). Le protocole comportait une analgesie peridurale ou par irrigation parietale de ropivacaine, la limitation des apports liquidiens intraveineux, la reprise rapide de l'alimentation orale et de la mobilisation active. Resultats. – Les delais median et moyen de sortie ont ete de 6 et 7,3 jours respectivement ; 36 operes (59 %) sont sortis entre le 3e et le 6e jour postoperatoire, huit (13 %) sont sortis au 7e jour et 17 (28 %) apres le 7e jour. Une sonde nasogastrique a ete necessaire chez deux operes (3,3 %). Il y a eu dix complications postoperatoires (16 %) et trois rehospitalisations (5 %). Il n'y a eu aucun deces. Conclusion. – Si le delai de sortie ne peut pas etre reduit au minimum dans tous les cas, un delai median nettement inferieur a ce qu'il est actuellement peut etre obtenu facilement par la mise en œuvre de quelques mesures volontaristes mais simples et peu couteuses. Outre les avantages pour l'opere, qui recupere plus vite ses fonctions normales, la reduction des couts merite d'etre prise en consideration a une epoque ou le probleme budgetaire est crucial.

We present a method to image Jones vector by use of digital holography. We demonstrate that with a single hologram acquisition, the method allows to image and to calculate Jones vector and derive the polarization parameters. The principle consists in using two reference waves polarized orthogonally that interfere with an object wave and to reconstruct separately the two wave fronts. Simulated and experimental data are compared to a theoretical model in order to evaluate the precision limit of the method for different polarization states of the object wave.

A method is proposed for designing apodized apertures with a transmission profile which follows a curve defined using a cubic spline interpolation. The method is applied in digital holographic microscopy to perform digitally the apodization of the aperture of holograms recorded by a CCD camera. The transmission of the apodized aperture is entirely defined by four parameters which are adjusted iteratively to minimize intensity and phase fluctuations appearing in the images obtained by numerical reconstruction of the holograms. The performances of the method have been studied in the absence of experimental sources of noise using a computer generated hologram with which we demonstrate that the aperture apodization reduces the standard deviation of the reconstructed phase distribution from 1.6 nm to 0.15 nm.

Noradrenaline (NA) kinetics represent an effective tool for evaluating the activity of the sympathetic system: thus plasma NA concentration, spillover rate (SOR) and metabolic clearance rate (MC) were measured in the rat. The dilution technique was adapted and validated: pithing that caused mechanical destruction of the spinal cord was shown to reduce drastically NA-SOR and plasma NA concentration with no effect on NA-MC. NA-SOR and plasma NA concentration were restored within their normal limits when 2.5 Hz electrical stimulation of the sympathetic roots was superimposed. Normal values of NA kinetics in non-anaesthetised normotensive 12-week-old rats are reported: NA-SOR=196.1+/-26.4 ng/kg/min, NA-MC=413.9+/-38.8 ml/kg/min and plasma NA=486+/-52 pg/ml. NA kinetic was investigated in response to anaesthesia, known to depress excitable tissues of the central nervous system and expected to depress the activity of the sympathetic system. When NA-SOR was significantly reduced during anaesthesia with either sodium pentobarbital or chloralose, plasma NA concentration was not changed because NA-MC was also reduced. Thus, plasma NA concentration can be a misleading marker of the sympathetic activity. The response of the sympathetic activity to four different anaesthetic agents is shown to be heterogeneous, ranging from inhibition to stimulation. Sodium pentobarbital anaesthesia was associated with a statistically significant reduction of both NA-SOR (105.6+/-14.1 ng/kg/min, P0. 01) and NA-MC (239.3+/-18.7 ml/kg/min, P0.001) while plasma NA was not changed (438+/-47 pg/ml). Chloralose reduced NA-SOR (101.6+/-20. 1 ng/kg/min, P0.05) while ketamine did not (150.6+/-35.5 ng/kg/min, n.s.): both compounds reduced NA-MC (257.9+/-27.8 ml/kg/min, P0.01 and 265.8+/-34.3 ml/kg/min, P0.05, respectively). Diethyl ether was shown to increase both NA-SOR (472.2+/-111 ng/kg/min, P0.05) and plasma NA concentration (1589+/-436 pg/ml, P0.01), while NA-MC remained unchanged. Thus, any investigation of the activity of the sympathetic system in the anaesthetised rat has to take into account the specific effects related to the anaesthetic agent used.

Interface dynamics separating homogeneous phases is shown to be the main mechanism underlying irregular evolution in 2D linearly stable, coupled map lattices. In a fully deterministic model belonging to this class, we find evidence of at least two different regimes that we call weak and strong turbulence. The transition between the two regimes is carefully investigated revealing a direct connection with the destabilization of the interfaces separating homogeneous phases. The critical behaviour is analysed and compared with that of stochastic models like directed percolation.

The aim of the present study was to investigate the possible role of erythrocytes in the metabolic clearance of catecholamines (CAs) in the rat. Intravenous infusion of exogenous CAs (dopamine -DA-, norepinephrine -NE-, or epinephrine -Epi-) was carried out at increasing doses to cover a range of plasma concentrations from the lower to the upper physiological and to pharmacological levels. Whatever the mechanism(s) underlying the CAs erythrocyte/plasma balance: 1. it seemed more efficient at lower concentrations of CAs; 2. it reached an apparent plateau where plasma and erythrocyte concentrations were not statistically different; 3. finally, saturation was suggested when further increase in plasma concentration was associated with a lower response in erythrocytes. This series of experiments confirms previous reported results with human erythrocytes and suggests that rat erythrocytes could transport CAs from their sites of release to their sites of elimination. In a second series of experiments, the intra-erythrocyte metabolism of CAs was investigated. DA was strikingly increased in plasma and in erythrocytes 2 hours after l,2-dimethyl-3-hydroxy-4-pyridone (CP20), 100 mg/kg i.p., known to inhibit catechol-O-methyl transferase. Our data demonstrate an increase in glucuro-conjugated DA in vivo ( 24 hours after CP20 injection) as well as in vitro (3 hours incubation at 37 °C), suggesting activation of the glucuroconjugating pathway. Increased glucuroconjugated DA after in vitro incubation demonstrates intra-erythrocyte synthesis while increased concentration in Ringer-Hepes medium demonstrates an insideout transport of glucuro-conjugate. These data are the first evidence in favour of an intra-erythrocyte glucuro-conjugation of CAs in the rat.

Psychiatrists may face impotence in two circumstances: the patient complains of his impotence, or suffers from depression or another psychiatric condition. It is in the way in which the patient and the symptom are approached by the psychiatrist that a confident and beneficial relation may be established.

The magnetic flux penetration in a high-quality YBa2Cu3O7−δ single crystal with an external field applied perpendicular to the crystalline c axis is directly visualized by means of the magneto-optical technique. The observations show that the field penetrates preferentially along the ab planes. Scanning acoustic microscopy reveals macrodefects along ab planes which strongly affect this anisotropy of the field penetration.

Pre-synaptic endings of the sympathetic nervous fibers control the metabolism of catecholamines, particularly inactivating norepinephrine after its neuronal recapture. The present study was carried out to investigate this segment of the metabolism of catecholamines through measurements of DHPG, DOMA and DOPAC concentrations in plasma. A sensitive and specific radio-enzymatic assay was developed of which the major characteristic is to include the plasma sample in the incubation mixture without initial extraction of the deaminated metabolites. In the rat, there was a statistically significant correlation between norepinephrine and DHPG in both anesthetized and conscious conditions and after clonidine or guanethidine induced reduction of sympathetic activity; thus it can be suggested that plasma DHPG is a good index of neuronal metabolism of norepinephrine in this animal. In humans, our data indicate an interesting correlation between norepinephrine and DOMA concentrations in plasma in resting conditions and within three hours after clonidine. Further studies need to be carried out to establish whether DOMA is a better index of neuronal metabolism of norepinephrine than DHPG.

Resume Nous rapportons une observation d'intoxication par antidepresseur tricyclique compliquee de deux episodes successifs de convulsions. Seule la serie de crises convulsives accompagnee d'acidose mixte et d'elevation de la noradrenaline plasmatique a ete associee a un elargissement des complexes QRS. Cette observation suggere qu'une trop forte dose de thiopental doit etre evitee et qu'une ventilation percritique efficace pourrait prevenir l'apparition de troubles conductifs graves.

A case of intraoperative subtotal obstruction of a reusable coiled expiratory breathing tube is reported. Partial occlusion by twisting was made possible by detachment of the coil from the external face of the tube after multiple reprocessings with high drying temperatures. A technique for tube checking before reuse is described.

The diffusion of extreme pressure-antiwear additives in synthetic lubricants has been studied by real-time holographic interferometry. The method and its advantages for the measurement of diffusion in oils are discussed. The diffusion coefficients of three phosphorus-containing molecules, used as model compounds, have been measured between 25 and 100 °C and very low values for the diffusion coefficients in liquid are reported. The results show that the additive structure has less influence on the diffusion coefficient than the oil viscosity. The relationship between the diffusion and the viscosity does not follow the Stokes formula and a new approximation is proposed.

Restraint stress is known to induce gastric ulcers in rats. Peripheral sympathetic activity and catecholamines are involved in the pathogenesis of these gastric ulcers. The aim of the present study was to evaluate the effects of restraint on mucosal and muscle catecholamine concentrations in the glandular stomach of rats. In unrestrained rats, noradrenaline concentration was higher in the muscle than in the mucosa of the glandular stomach (629 +/- 106 vs 18 +/- 3 pg/mg and 217 +/- 37 vs 18 +/- 8 pg/mg, respectively in the corpus and the antrum, p less than 0.01). This can be explained by the existence of an abundant noradrenergic innervation in the muscle layer. After 20 hours of restraint, adrenaline and noradrenaline concentrations were significantly decreased in adrenals, in comparison with unrestrained animals (255 +/- 53 vs 638 +/- 160 ng/mg and 113 +/- 17 vs 198 +/- 37 ng/mg, respectively for adrenaline and noradrenaline, p less than 0.05). In the glandular stomach, noradrenaline and adrenaline concentrations in restrained rats were not significantly different from those in unrestrained rats. However, adrenaline concentrations in the muscle of restrained rats were higher than in the mucosa. Moreover, restraint induced a significant decrease in dopamine concentration in the antral mucosa (from 100 +/- 12 pg/mg in unrestrained rats to 15 +/- 5 pg/mg in restrained rats), suggesting that a depletion in dopamine in the antral mucosa could be one of the pathogenetic factors involved in antral gastric stress-induced ulcers in rats.

Les sels de para-aminobenzoate appartiennent au groupe des vitamines B et sont connus depuis 1863. Le para-aminobenzoate de sodium est un photoprotecteur et le para-aminobenzoate de potassium (Potaba®) est utilise dansle traitement de la sclerodermie et de la maladie de La Peyronie (induration sclereuse des corps caverneux) [1, 2]. Nous rapportons trois cas d'hepatite associee a la prise de Potaba®.