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Dieser Beitrag untersucht das Verhältnis zwischen Diskurs und Körper/Körperlichkeit. Die These des Autors und der Autorin ist, dass dieses Verhältnis ein zweifaches ist: Zum einen kann der Körper in einen Diskurs eingeschrieben werden und zum anderen kann er als Oberfläche für die Einschreibung eines oder mehrerer Diskurse dienen.

This paper presents the properties of the minimum mean cycle-canceling algorithm for solving linear programming models. Originally designed for solving network flow problems for which it runs in strongly polynomial time, most of its properties are preserved. This is at the price of adapting the fundamental decomposition theorem of a network flow solution together with various definitions: that of a cycle and the way to calculate its cost, the residual problem, and the improvement factor at the end of a phase. We also use the primal and dual necessary and sufficient optimality conditions stated on the residual problem for establishing the pricing step giving its name to the algorithm. It turns out that the successive solutions need not be basic, there are no degenerate pivots, and the improving directions are potentially interior in addition to those on edges. For solving an m × n linear program, it requires a pseudo-polynomial number O ( n Δ ) of so-called phases, where Δ depends on the number of rows and the coefficient matrix.

Mastitis and abscess of the newborn breast are serious infections. The objective of our study was to describe the epidemiological and therapeutic aspects of these infections in our context.This was a retrospective study from January 2017 to December 2019. We included all children aged ≤2 months admitted for mastitis or breast abscess. The variables studied were epidemiological and therapeutic.We collected 34 files, i.e., 11.3 cases/year. The sex ratio was 0.5. The mean age was 16.3 ± 6.6 days. The mean time to the consultation was 3.7 ± 2.4 days. The parents had undertaken a massage in 79.4% of cases. It was mastitis in 12 cases and abscess in 21 cases. Treatment was surgical in 26 cases.This affection is frequent with a female predominance. Its management must be early. The proscription of breast massage would reduce its frequency.

Diseases characterized by long distance inoculum dispersal (LDD) are among the fastest spreading epidemics in both natural and managed landscapes. Management of such epidemics is extremely challenging because of asymptomatic infection extending at large spatial scales and frequent escape from the newly established disease sources. We compared the efficacy of area- and timing-based disease management strategies in artificially initiated field epidemics of wheat stripe rust and complemented with simulations from an updated version of the spatially explicit model EPIMUL, using model parameters relevant to field epidemics. The model was further used to expand the number of epidemic mitigations beyond that feasible to incorporate in the field. The field experiment was conducted for 2 years in two locations having different climatic conditions. Culling and protection treatments were applied at different times after epidemic initiation and to different spatial extents surrounding the outbreaks. In each experiment, treatments were replicated four times in plots 33.5 m long and 1.52 m wide with a 0.76 × 0.76 m inoculated focus centered within each plot. Disease gradients were assessed along the center lines of the plots at 1.52 m intervals both upwind and downwind from the focus. Both field and simulation results indicated that control measures applied over the entire population were highly effective in suppressing the epidemics by more than 99% but may not always be logistically and economically feasible at large spatial scales. Comparison between the variable sized treatment areas and application timings suggested that implementing contiguous premises (CP) cull at 1 day after first sporulation in the outbreak focus reduced rust by 52% and 60% in Corvallis and Madras, respectively. However, altering the cull size did not significantly affect the disease epidemic development, which suggested that early timing had a greater influence in suppressing the epidemics than did increased area of application. However, sufficiently large, treated areas may compensate for a delay in application timing to some extent. Results from these replicated treatments may help to devise appropriate management strategies for other LDD pathogens.

International audience; Rationale: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown.Objectives: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2

Resume Objectifs En appui sur les donnees issues d’une vaste recherche medico-psychopathologique proposee a des jeunes filles atteintes d’une agenesie utero-vaginale — syndrome de Rokitansky ou Mayer-Rokitansky-Kuster-Hauser (MRKH) — notre travail propose l’analyse psychodynamique de la valeur et de la fonction pour l’economie psychosomatique d’une reaction frequente a l’annonce diagnostique : le developpement d’un desordre alimentaire de type prise de poids chez 4 patientes sur 40. La mise en perspective de l’analyse de deux cas de patientes permet d’affiner la comprehension du sens de cette emergence alimentaire dont nous faisons l’hypothese qu’elle constitue a la fois une modalite defensive signalant les impasses du processus de construction du feminin mais aussi possiblement un levier de transformation psychique de ses incidences traumatiques. Methode Quarante jeunes femmes MRKH âgees de 19 a 34 ans (avec un âge moyen de 25 ans ½) ont ete rencontrees. La recherche leur a ete proposee de 2 a 17 ans apres leur annonce diagnostique et le travail clinique a consiste en une analyse retrospective de leur experience traumatique adolescente. Le recit des patientes a ete recueilli a l’aide d’un entretien clinique a visee de recherche non directif. Deux epreuves projectives (Rorschach et Thematic Apperception Test – TAT) leur ont egalement ete proposees pour apprehender plus finement les modalites de leur fonctionnement psychique. Les donnees des entretiens font l’objet d’une analyse clinique thematique ; les protocoles du Rorschach et du TAT sont analyses selon la methode d’interpretation de l’Ecole Francaise referee a la theorie psychanalytique du fonctionnement psychique. Le materiel issu des rencontres avec deux patientes diagnostiquees a l’âge de 17 ans et ayant presente dans la suite de cette annonce une prise de poids de 10 kg est ici compare de maniere approfondie. Resultats Le reperage de contrastes en termes de problematiques et de niveaux d’elaboration entre l’entretien et les protocoles projectifs est saisissant pour chaque patiente. A travers l’analyse de l’entretien, le symptome alimentaire de la patiente 1 parait survenir dans un contexte psychique ou l’interiorite feminine semble irrepresentable. Les protocoles projectifs revelent a l’inverse l’acces a un travail du feminin conflictuel et symbolise. De meme, le discours de la patiente 2 sur son symptome est a premiere vue bien plus elabore que celui de la patiente 1 puisque celle-ci etablit un lien subjectif entre le renoncement au projet de maternite implique par l’annonce du MRKH et la dimension compensatoire procuree par la prise de poids. Pourtant, le contraste offert par les tests projectifs dont les productions traduisent au contraire les fragilites identitaires et une insuffisante symbolisation du sexuel temoigne de la valeur defensive de l’exces de symbolisation de son discours manifeste dans l’entretien. Discussion Ces contrastes amenent a envisager le remplissage alimentaire comme une tentative de traitement d’une sexualite feminine deja conflictuelle voire en impasse avant la decouverte du MRKH. Ses accents traumatiques sont reactualises et potentialises a la faveur de l’annonce diagnostique. Les differents niveaux de problematiques reperes peuvent cohabiter chez une meme femme, qu’il s’agisse d’un feminin ni construit ni integre, d’un impossible investissement du corps interne ou d’un contre-investissement de l’impossible maternite. Dans ce contexte, l’etiopathogenie de la prise de poids qui succede a l’annonce du diagnostic est pour chaque jeune fille singuliere mais toujours en lien avec un feminin et/ou un maternel atteint. Conclusion En conclusion, si la prise de poids qui suit le diagnostic traduit une entrave voire une impasse (eventuellement ponctuelle) du traitement psychique de ses effets, cette annonce medicale a l’adolescence peut constituer une nouvelle chance pour ces jeunes filles, celle d’un apres-coup a la valeur potentiellement mutative.

The clinical diagnosis of a torsion of an ectopic testicle is difficult. Lack of knowledge on this pathology is often a cause of late diagnosis and can have serious consequences. This diagnosis should be made in front of any acute pelvic or inguinal pain in children with an ectopic testicle, regardless of age. We report a case of late presentation of a 6 month-old infant with torsion of an ectopic testicle leading to testicular necrosis.

In the MITICA (Mother‐to‐Infant TransmIssion of microbiota in Central‐Africa) study, 48 mothers and their 50 infants were followed from delivery to 6 months between December 2017 and June 2019 in Bangui (Central‐African Republic). Blood tests and stool analyses were performed in mothers at delivery, and their offspring at birth, 11 weeks and 25 weeks. Stool cultures were performed in specific growth media for Salmonella, Shigella, E. coli, Campylobacter, Enerobacter, Vibrio cholerae, Citrobacter and Klebsiella, as well as rotavirus, yeasts and parasitological exams. The median vitamin C levels in mothers at delivery were 15.3 μmol/L (inter‐quartile‐range [IQR] 6.2–27.8 μmol/L). In infants, the median vitamin C levels at birth were 35.2 μmol/L (IQR 16.5–63.9 μmol/L). At 11 and 25 weeks, the median vitamin C levels were 41.5 μmol/L (IQR 18.7–71.6 μmol/L) and 18.2 μmol/L (IQR 2.3–46.6 μmol/L), respectively. Hypovitaminosis C was defined as seric vitamin C levels

Solitary bone plasmacytoma is a rare plasmocytic neoplasm accounting for about 5% of all plasmocytic neoplasms. It is usually presented as a lytic lesion mainly localized in the axial skeleton. Its presence in adolescents is extremely rare. It is unheard of in children. We report a case of solitary plasmacytoma of the iliac bone in a 7-year-old girl with a history of trauma to the iliac bone.

Background: Heavy schoolbag is known to cause health problems for school children. The aim of this study was to determine the effects of carrying heavy schoolbags on the musculoskeletal pain among primary school children of the two subsystems in Yaounde, Cameroon. Methods: A cross-sectional study was carried out in primary schools in Yaounde. A total of 457 school-children (8.2 ± 2.2 years) were included, 202 from the French-speaking subsystem, and 255 from the English-speaking subsystem. Parameters studied included weight, height, and schoolbag weight. A questionnaire was used to collect socio-demographic information and potential musculoskeletal pain in three regions: back, shoulders, and neck. Results: The mean weight of children and their bags was 28.4 ± 8.2 kg and 5.2 ± 2.3 kg respectively. More than 50% of schoolchildren in the two subsystems carried a schoolbag weighing more than 15% of body weight. The back (38%) was the least affected area in comparison to the shoulders (58.6%) and neck (42.4%) (p < 0.001). Carrying heavy bags and walking to school was associated with pain in the back, shoulders, and neck. School-children in the French-speaking subsystem had lower risk (adjusted Odds Ratio 0.438, 95% CI = 0.295-0.651; p < 0.001) to develop a sore neck compared to peers from the English-speaking subsystem. Conclusion: Carrying heavy schoolbags is associated to musculoskeletal pain in schoolchildren. The means moving to and from school is a main risk factor of developing musculoskeletal pain. French-speaking schoolchildren develop less neck pain than English-speaking schoolchildren.

Introduction la paralysie obstétricale du plexus brachial est une affection relativement rare mais qui n´a pas disparu malgré les importants progrès en obstétrique. L´objectif de cette étude était de décrire les aspects épidémiologiques, thérapeutiques et évolutifs de cette affection dans notre contexte. Méthodes analyse rétrospective sur deux ans des dossiers de nouveau-nés ayant présenté une paralysie obstétricale du plexus brachial et pris en charge au Centre Hospitalier Universitaire de Bouaké. Les enfants reçus après l´âge de 3 mois n´ont pas été inclus. Les variables étudiées étaient d´ordre épidémiologique, thérapeutique et évolutif. Résultats soixante patients ont été colligés, soit une fréquence de 28,5%. Il y avait 31 (52%) filles. L´âge moyen était de 8 jours [J0 et J35]. Les mères étaient multipares dans 94% des cas. L´accouchement a eu lieu dans un centre de santé dans 97% des cas. Tous les enfants étaient nés à terme avec 57 (95%) présentations céphaliques. L´accouchement était eutocique dans 74% des cas. Le poids moyen de naissance était de 3604g [2150g et 4500g]. Il y avait 47 cas (78%) de paralysie C5-C6. L´immobilisation coude au corps associée à la rééducation a été réalisée chez 51 enfants (85%). La rééducation a été réalisée immédiatement chez 9 enfants (15%). La récupération fonctionnelle du membre lésé a été complète chez 50 enfants (83%) après un recul de 6 mois. Conclusion la paralysie obstétricale du plexus brachial demeure une affection obstétricale d´actualité. Son traitement conservateur, seule alternative dans notre contexte donne de bons résultats.

We develop an algorithmic framework for linear programming guided by dual optimality considerations. The solution process moves from one feasible solution to the next according to an exchange mechanism that is defined by a direction and a resulting step size. Part of the direction is obtained via a pricing problem devised in primal and dual forms. From the dual perspective, one maximizes the minimum reduced cost that can be achieved from splitting the set of dual variables in two subsets: one being fixed while the other is optimized. From the primal perspective, this amounts to selecting a nonnegative combination of variables entering the basis. The direction is uniquely complemented by identifying the affected basic variables, if any. The framework is presented in a generic format motivated by and alluding to concepts from network flow problems. It specializes to a variety of algorithms, several of which are well known. The most prominent is the primal simplex algorithm where all dual variables are fixed: this results in the choice of a single entering variable commonly leading to degenerate pivots. At the other extreme, we find an algorithm for which all dual variables are optimized at every iteration. Somewhere in between these two extremes lies the improved primal simplex algorithm for which one fixes the dual variables associated with the nondegenerate basic variables and optimizes the remaining ones. The two last variants both bestow a pricing problem providing necessary and sufficient optimality conditions. As a result, directions yielding strictly positive step sizes at every iteration are also issued from these pricing steps. These directions move on the edges of the polyhedron for the latter while the former can also identify interior directions.

The primary abscess of the psoas of the child is a rare affection, the pathogenesis of which is still unexplained. The positive diagnosis of this condition is difficult and relies mainly on medical imaging. We report a case of primary psoas abscess in an immunocompetent child, whose diagnosis was facilitated by the provision of abdominal radiography without preparation and abdominal ultrasound. The evolution was favorable thanks to the combination of antibiotic therapy and surgery.

Objective: To analyze our experience in the management of ovarian hernia in children. Methods: It was a retrospective study about 11 cases treated in pediatric surgery unit of the Teaching Hospital of Bouake, in 2 years period. Results: Ovarian hernia represented 7.69% of the hernias and 73.33% of the hernia cases in girls. The mean age was 4 years and the median 36 months. The main reason for consultation was inguinal swelling (45.45%) following by swelling of the labia majora (36.36%), and a round mass of labia majora palpated by parents while bathing the child (18.18%). Nine (9) patients had been operated on; we realize the closure of peritoneo-vaginal canal, associated in 66.66% cases with a routine surgical exploration of the contralateral side. Average age of these children with contralateral hernia was 20 months. The mean follow up was 6 months (15 days - 15 months). We noticed an appearance of contralateral ovarian hernia in a girl operated on at 3 years old without routine surgical exploration. Conclusion: We recommend early management with a systematic surgical exploration of the contralateral side in young female child. A preoperative ultrasonography could be a routine in case of strangulated hernia, if available.

Osteomyelitis is a frequent pathology in the pediatric population. It is usually located on the fertile metaphyses of the long bones. However, there are rare locations such as short and flat bones. We report a case of chronic suppurative osteomyelitis in a scapular location in a 2-month-old infant with a late diagnosis. The identified germ was Staphylococcus aureus. The X-ray showed images of osteolysis of the scapula. Treatment consisted of double antibiotic therapy and drainage of the abscess with bone sequestrectomy, supplemented by immobilisation. The evolution was favorable after 2 years.

This paper addresses the solution of the capacitated minimum cost flow problem on a network containingn nodes and m arcs. Satisfying necessary and sufficient optimality conditions can be done on the residual network although it can be quite time consuming as testified by the minimum mean cycle-canceling algorithm (MMCC). We introduce a contracted network which exploits these conditions on a much smaller network. Since the construction of this contracted network is very flexible, we study its properties depending on the construction choice. A generic contraction algorithm is then produced around the contracted network. Interestingly enough, it turns out it encapsulates both the MMCC and primal network simplex algorithms as extreme cases. By guiding the solution using a particular expansion scheme, we are able to recuperate theoretical results from MMCC. As such, we obtain a strongly polynomial Contraction-Expansion algorithm which runs in O(m3n2) time. There is thus no improvement of the runtime complexity, yet the expansion scheme sticks to very practical observations of MMCCs behavior, namely that of phases and jumps on the optimality parameter. The solution time is ultimately significantly reduced, even more so as the size of the instance increases.