Trajectories of perceived economic hardship: Relations with mother's and child's mental health and the role of self-esteem.

Trajectories of poverty influence the mental health of mothers and children. Previous studies utilize objective measures despite the importance of subjective measures of poverty. Furthermore, chronic economic hardship may erode personal resources such as self-esteem which increases vulnerability to mental health issues. Trajectories of perceived family economic hardship and their relationship with common mental health disorders, as mediated by self-esteem, were investigated in 511 mother-child dyads from Singapore. Three distinct groups of economic hardship trajectories were delineated, namely the low stable, high stable and moderate decreasing group. The high stable group was found to be associated with a greater likelihood of mother's depression, mother's anxiety and child's anxiety when compared to the low stable group. The moderate decreasing group was found to be associated with a greater likelihood of mother's anxiety when compared to the low stable group. Mother's self-esteem was found to mediate all the significant relations found. These findings indicate the existence of distinct trajectories of perceived economic hardship within low-income families and their relation with mental health outcomes in mothers and children. The mediation of these relations by mother's self-esteem suggests the importance of enhancing self-esteem in mothers from low-income backgrounds.

IFNγ-Stimulated B Cells Inhibit T Follicular Helper Cells and Protect Against Atherosclerosis.

B and T cells are interconnected in the T follicular helper-germinal center B cell (TFH-GC B cell) axis, which is hyperactive during atherosclerosis development and loss of control along this axis results in exacerbated atherosclerosis. Inhibition of the TFH-GC B cell axis can be achieved by providing negative co-stimulation to TFH cells through the PD-1/PD-L1 pathway. Therefore, we investigated a novel therapeutic strategy using PD-L1-expressing B cells to inhibit atherosclerosis. We found that IFNγ-stimulated B cells significantly enhanced PD-L1 expression and limited TFH cell development. To determine whether IFNγ-B cells can reduce collar-induced atherosclerosis, apoE -/- mice fed a Western-type diet were treated with PBS, B cells or IFNγ-B cells for a total of 5 weeks following collar placement. IFNγ-B cells significantly increased PD-L1hi GC B cells and reduced plasmablasts. Interestingly, IFNγ-B cells-treated mice show increased atheroprotective Tregs and T cell-derived IL-10. In line with these findings, we observed a significant reduction in total lesion volume in carotid arteries of IFNγ-B cells-treated mice compared to PBS-treated mice and a similar trend was observed compared to B cell-treated mice. In conclusion, our data show that IFNγ-stimulated B cells strongly upregulate PD-L1, inhibit TFH cell responses and protect against atherosclerosis.

[Correlation between ICIQ-UI-SF score and personality testing results over a urinary incontinent population]. / Corrélation entre le score de l'ICIQ-UI-SF et les résultats d'un test psychométrique de personnalité d'une population ayant une incontinence urinaire.

OBJECTIVE: We found out the personality pattern of an incontinent population and proceeded to a correlation between the personality inventory and the ICIQ-UI-SF (International Consultation Incontinence Questionnaire Urinary Incontinence Short Form) to demonstrate reliability and sincerity of the answers and to establish that a personality disturbance may impact the physiopathology of micturition. MATERIALS AND METHODS: We performed an observational prospective study. It included patient's answers to a computed questionnaire combining a double ICIQ-UI-SF questionnaire and the 71 questions of the Minimult questionnaire. Forty-seven patients were asked to participate. RESULTS: Over 37 patients included, Wilcoxon-Mann-Whitney non parametric test confirmed agreement of the two ICIQ-UI-SF questionnaires with P=0.1792. Twenty-three patients were validated to the Minimult inventory with F scale<70. We analysed variability of the two global ICIQ-UI-SF score in regard with the validity scale using ROC analysis. We observed an AUC of 0.559 with sensitivity 78.6% and specificity 43.5%. No L score was above 70 demonstrating absence of lie. No personality disturbance was found in 9 cases. We observed six cases with a high hypochondric value, five with a high depressive value, and four with a high hysteric value. This neurotic triad was found in two cases. We noticed five cases with psychopathic deviance relative to antisocial behaviour while values of paranoia and hypomania were high in one case without any association of these personality aspects, which demonstrated absence of behavioural problem. Psychotic profile associating schizophrenia, paranoia, depression and hypomania was not found. We outlined in half of the valid population a significant high psycho-asthenic pattern. CONCLUSION: We conclude that a correlation between the personality inventory and the ICIQ-UI-SF is feasible. The comparative study demonstrate reliability of answers. Sincerity is established by the Minimult L scale. We confirm and precise literature information over clinical personality pattern of this population and observe relevant elements concerning the psycho-asthenic pattern which depicts an anxious personality with an important feeling of the problem. These elements permit to suspect that a personality disturbance may impact the physiopathology of the micturition. LEVEL OF EVIDENCE: 4.

Therapeutic processes in multi-family groups for major depression: results of an interpretative phenomenological study.

BACKGROUND: Recent research indicates that different couple and family interventions are effective in the treatment of depressed patients. However, how these psychosocial interventions work, has been less well investigated. In order to better understand the underlying treatment processes, helpful treatment experiences of depressive patients and their partners were examined in a multi-family therapy group. METHOD: 24 patients hospitalized for depression and 20 partners participated in this study. Therapeutic factors were assessed using an open-ended questionnaire. Responses were analyzed using interpretative phenomenological approach (IPA). RESULTS: Eight recurring therapeutic factors were reported by both the patients and their partners: (1) Presence of others, (2) cohesion and understanding, (3) self-disclosure, (4) openness, (5) discussion, (6) insights, (7) observational experiences and (8) guidance from the therapist. LIMITATIONS: Results were not fed back to the participants following analysis and only therapeutic factors that operate on a conscious level could be identified. CONCLUSIONS: Several important therapeutic factors were identified in multi-family therapy groups for depression. These factors help to gain understanding into the processes, which should be emphasized in treatment and ought to be explored in future outcome and process research.

Supervisory attentional system in nonamnesic alcoholic men.

BACKGROUND: Many studies have shown that recently detoxified alcoholic persons perform poorly on tasks thought to be sensitive to frontal lobe damage, supporting the hypothesis that the frontal lobes are highly vulnerable to chronic alcohol consumption. However, it appeared that most of the executive tasks used in these studies also involved nonexecutive components, and these tasks had been shown to be impaired as a result of nonfrontal lobe lesions. In this study, we examined further the "frontal lobe vulnerability" hypothesis using executive tasks, proved to be associated with frontal lobe functioning, that allowed us to distinguish the relative importance of executive and nonexecutive processes. METHOD: Thirty recently detoxified asymptomatic male alcoholic inpatients and 30 control subjects were tested for planning, inhibition, rule detection, and coordination of dual task, as well as the speed of processing and nonexecutive functions (such as short-term memory storage). RESULTS: Alcoholics performed worse than controls in almost all tasks assessing executive functions. However, they were not slower than the controls and showed normal results for nonexecutive functions. CONCLUSIONS: Chronic alcohol consumption seems to be associated with severe executive function deficits, which are still present after a protracted period of alcohol abstinence. These data support the idea that the cognitive deficits in recently detoxified sober alcoholic subjects are due, at least partly, to frontal lobe dysfunctioning.

Correlation between inhibition, working memory and delimited frontal area blood flow measure by 99mTc-Bicisate SPECT in alcohol-dependent patients.

Recently detoxified non-neurological alcoholic patients appear to be impaired in cognitive tasks measuring inhibitory processes as well as working memory (involving storage and manipulation of information). The aim of this study was to investigate in alcoholic participants the relationship between these two cognitive functions and regional cerebral blood flow (rCBF) studied at rest in regions of interest selected on the basis of recent PET studies which explored inhibitory and working memory in normal subjects. Twenty non-neurological alcoholic patients and 20 normal volunteers were selected for a neuropsychological exploration, including assessment of inhibition processes (by means of the Hayling test) and working memory (by means of the Alpha-span task). rCBF of alcoholics was also evaluated with a semi-quantitative method using a 99mTc-Bicisate single photon emission computed tomography (SPECT) procedure. Alcoholic patients performed worse than controls in the alphabetical condition of the Alpha-span task (involving manipulation and storage of information), and on the Hayling test. Significant correlation emerged between inhibition performance and both the bilateral inferior (left BA 47, r = -0.40; right BA 47, r = -0.599) and median frontal gyrus (left BA 10, r = -0.55; right BA 10, r = -0.59), but not with the region of reference (occipital/cerebellum, r = -0.13). Coordination of storage and manipulation was correlated with bilateral median frontal (left BA 10/46, r = -0.50; right BA 10/46, r = -0.45), but not with bilateral parietal area (left BA 7, r = -0.12, right BA 7, r = -0.18). These results suggest a relationship between inhibition and working memory deficits in alcoholic patients, and regional rCBF measured in frontal areas. Clinical implications of these data related to alcohol relapse are discussed.

An atypical neuropsychological profile of a Korsakoff syndrome patient throughout the follow-up.

The basis of amnesia in alcoholic Wernicke-Korsakoff syndrome (WKS) has been generally associated with diencephalic lesions and more specifically with lesions of the anterior thalamic nuclei. These brain structures are considered to be involved in encoding/consolidation processes of episodic memory. However, frontal lobe damage responsible for executive function deficits has also been documented. The present report details the nature and extent of amnesia in an alcoholic patients with WKS and which appears to be mainly due to frontal lobe (executive) deficits.

[Clinical and psychometric study of post-traumatic stress disorders following acts of violence]. / Etude clinique et psychométrique des états de stress post-traumatiques après agression.

Fifty victims of assaults and hold-ups underwent a medical and psychological examination in order to assess the semiological and psychometric features of post-traumatic stress disorder: 27 males and 23 females with a mean age of 41 years were examined 18 months after the traumatic event. The following semiology was observed: excitability, phobic avoidance, distrust, recurrent traumatic nightmares, difficulties in concentration, impaired memory, dysphoric mood, hyperfatigability, recurrent recollection of the traumatic event, headache, middle and terminal sleep disturbances and neurovegetative hyperreactivity. Testing demonstrated anxious and depressive troubles and moderate cognitive disturbances. Statistical study showed no correlation between type of aggression (psychological trauma with or without concomitant physical component) and cognitive and psycho-affective variables. Most of the cognitive disturbances were correlated with the severity of anxiety and depression. Post-traumatic stress disorder also perturbed the work capacity: only 8 patients resumed previous activities after a lapse of time of 1-54 months.

Portal vein thrombosis after acute pancreatitis: diagnostic confirmation with computed tomography during arterial portography.

Portal vein thrombosis is a rare complication of pancreatic inflammatory disease. Usually, the radiologic diagnosis is made either by ultrasonography, contrast-enhanced CT or angiography. Moreover, MRI seems a very promising method. CT during arterial portography (CTAP) focused on portal system proved to have a place in the evaluation of portal vein thrombosis in a particular case.

[Post-traumatic dementia]. / Les démences post-traumatiques.

On the basis of a retrospective study concerning 63 cases of normal pressure hydrocephalus, the author examines the characteristics of patients with a traumatic aetiology who were not ameliorated by a ventricular derivation. Four of these patients suffering from a post-traumatic dementia are described. Reviewing the literature, several topics concerning post-traumatic dementia are considered: incidence, time delay before diagnosis, variation of pictures, aetiopathogenic explanations, medico-legal problems encountered with Alzheimer's of Pick's diseases. Finally the differential diagnostic characteristics between the curable and incurable forms of post-traumatic dementia syndromes are discussed.

[Fetal alcoholism syndrome: apropos of a case]. / Le syndrome d'alcoolisme foetal: à propos d'un cas.

Fetal alcoholic syndrome (F.A.S.) is a well-recognized entity for over 20 years; it associates mental retardation, delayed growth and anomalies of the cranium in children born from alcoholic mothers. The syndrome has been described primarily in young children. By contrast, its evolution is not well known. We report the case of a 15-year old youngster, who exhibited the characteristic features of F.A.S. We also review the data related to the clinical and pathophysiologic aspects of the syndrome.

Effects of methionine hydroxy analog on voluntary intake, digestibility, nitrogen balance, and chewing behavior in sheep fed grass silage.

Voluntary intake, digestibility, N balance, and chewing behavior of six 6-mo-old (young) and six 30-mo-old (mature) Texel wethers (32.6 and 83.1 kg average BW) given ad libitum access to grass silage and 100 g of top-dressed soybean meal with or without 5 g of methionine hydroxy analog (MHA) in the acid form were examined according to a two-period crossover design. Supplementation level of MHA in the acid form corresponded to .32 and .16 g of MHA/kg BW.75, respectively, in young and mature wethers. There was no effect (P greater than .10) of MHA on mean voluntary DMI. Methionine hydroxy analog supplementation increased (P less than .02) digestibility of DM, OM, and CP by young wethers but not (P greater than .18) by mature wethers. The MHA decreased eating time (P less than .03) in both young and mature wethers and intake level (P = .01) in young wethers during the first 1.5 h of access to grass silage. With MHA, both age groups increased (P less than .05) the daily number of meals and decreased (P less than .02) the mean duration of each meal. There was no effect (P greater than .06) of MHA on daily and unitary eating, ruminating, and masticating times; however, mean duration of consecutive rumination bolus cycles was longer (7.2%; P = .01) in young wethers. Young vs mature sheep ate more (53.4 vs 39.3 g of DM/[d.kg BW.75]; P less than .001) and had shorter unitary mastication times (P = .001). Results suggest that, depending on its relative level of supplementation, MHA in the acid form could act through both palatability and effects on ruminal metabolism.

[Hydrocephalic and/or degenerative dementia]. / Démence hydrocéphalique et/ou dégénérative.

The authors report ten cases of progressive dementia. Nine are associated with gait disturbances and seven with urinary incontinence. Despite the severity of dementia and Ct Scan signs of cortical atrophy, magnitude of neuroradiological ventricular dilatation and ventricular reflux at isotopic cisternography lead to shunt therapy. After ventricular shunting of CSF, a follow-up at short and long terms shows different clinical evolutions: two transitory improvements, three cases without change and five worsening. Retrospective clinical study of these cases in which diagnosis leads to a degenerative process of the Alzheimer type shows atypical premorbid neuropsychological characteristics by a normal-pressure hydrocephalus. In fact, in the ten cases preoperative neuropsychological investigation shows, at various levels, aphasic, alexic and agraphic signs. Their occurrence in the clinical picture represents an essential contribution to differential diagnosis.

Clonidine-induced growth hormone secretion in elderly patients with senile dementia of the Alzheimer type and major depressive disorder.

This study was undertaken to assess the value of growth hormone (GH) response to clonidine as a tool in the differential diagnosis between depression and dementia. This response is known to be blunted in depression, and neurochemical changes observed in senile dementia of the Alzheimer type (SDAT) could lead to an up-regulation of GH secretion. No difference was observed between GH response in depressed and demented patients. Together with studies on GH basal secretion in Alzheimer's disease, this finding suggests that the final consequence of SDAT-related changes in an accentuation of the effects of aging on GH reactivity.

[Epileptic psychosis--ictal psychosis?]. / Psychose épileptique--psychose ictale?

A 54-year-old female patient presented acute hallucinatory psychotic episodes with irritative EEG for seven years before an initial state of complex partial mal. A single convulsive episode occurred 14 years after the beginning of the psychiatric symptoms. The intercritical EEG showed independent temporal lobe foci predominating on the right. It varied little during delirious phases but these occurred three times during weaning from antiepileptic drugs. The delirium improved when the treatment was restored, whereas neuroleptics proved ineffective. Psychiatric signs frequently described in epilepsy and particularly temporal epilepsy are reviewed. Usually, these symptoms are not concomitant. The literature mentions only a very few cases where psychosis appears to be ictal as in the reported case.

Psychological sequelae after head traumas in adults.

Head trauma can generate various psychopathological sequelae either in intellectual functions or personality. The post-traumatic sequelae that are focused on in this work are memory disturbances, dementia and personality problems. It partially sums up fifteen years of psychological studies on head injuries conducted in the department of neurosurgery of Prof. Jean Brihaye.

[Rorschach test and post-traumatic depressive syndromes]. / Test de Rorschach et syndromes dépressifs post-traumatiques.

After reviewing the literature on post-concussional syndrome in head injured patients and some studies which have contributed to objectify post-traumatic personality characteristics, the authors were particularly interested in studying depressive signs complained of by such patients without any psychopathological history. The analysis of a group of 47 head injured patients shows that one in two patients openly revealed such depressive tendencies. These patients, who were observed on average less than one year after the trauma, do not differ from the others, whether by age, sex, the severity of the head injury, the existence of a neurosurgical operation. However, they showed many symptoms which were different from those of the other patients in the group and different from those of the whole group. This "depressive" syndrome appears in a more specifically anxious form. The study of the Rorschach's test, on the other hand, does not show any change in the basic personality, especially inhibited in the two groups. For the patients who do not complain openly of depressive signs, the hypothesis of a masked depression was raised. This perspective is compared with the literature's data and allowed to point out several forms of post-traumatic depression.

[Computer hardware for a surgical service]. / Over de hardware bij computing in een heelkundige dienst.

While the bulk of all medical information is text, we think that the hardware needed to collect this information and to store it in a databank, must be essentially a first class work processor, working in a multi-user system with terminals where this information is gathered: the nursing stations, operating theatres, outpatient clinics and a working and archiving station centrally placed and capable to link those different terminals and those from other services as well.

[Neuropsychological symptomatology in normal pressure hydrocephalus]. / Sémiologie neuropsychologique dans l'hydrocéphalie à pression normale.

The neuropsychological observations of 63 patients undergoing surgery for "normal pressure hydrocephalus" (NPH) have been analyzed retrospectively. To make a semiological picture of mental disturbances in NPH, the level of consciousness, behaviour and cognitive functions were studied. A neuropsychological investigation of the main cognitive functions (language, gnosis, praxis, calculation, memory) enables us to specify the characteristics of dementia shown by these patients. A mental picture of the most frequent neuropsychological signs is described. The mental syndrome which characterized NPH reveals an alteration of alertness and concentration, a deficiency in memory, a disorganization of graphism (writing and drawing), a dyscalculia and behaviour problems (bradypsychy, apathy, indifference). Such a syndrome points out a bilateral frontal lesion. On the other hand, the less frequent signs are largely verbal and show different stages of aphasia. These signs can usually be found in patients who don't improve after ventricular drainage and are more suggestive of a degenerative disease of the Alzheimer type. The results are compared with the psychometric and neuropsychological data of the literature. More specific attention is accorded to differential diagnosis.

Pilonidal sinus. Excision--marsupialization--phenolization?

Too often still this disease is called sacrococcygeal cyst, pointing into the direction of congenital etiology. With this paper (and a review of the literature) we try to proof that the theory of acquired origin of pilonidal sinus is the only one logically to be accepted. We indicate that extensive surgical procedures such as Z-plasty rotated flap or broad excision--are really unnecessary and that a simple and accurate technique--marsupialization--gives excellent results with a minimum of recurrences. The last few years phenolization of the pilonidal sinus has become a popular, and eventually a worthwhile alternative.