[Management of sexual side effects of antidepressants]. / Prise en charge des effets secondaires sexuels des antidépresseurs.

Antidepressants are associated with a high risk of sexual dysfunction. Their sexual side effects are greatly underestimated in clinical practice because they are rarely discussed spontaneously by the patient and poorly investigated by clinicians. Nonetheless, they are responsible for a decrease in quality of life as well as a decrease in treatment adherence, leading to a risk of relapse or worsening of the treated mental pathology. This is particularly problematic as antidepressants are often needed on a long-term basis and spontaneous remission of these sexual side effects is low. Prevention, investigation and handling of sexual side effects are therefore important goals in the management of patients treated with antidepressants.

Les antidépresseurs sont associés à un risque élevé de dysfonctions sexuelles. Leurs effets secondaires sexuels sont largement sous-estimés dans la pratique clinique car ils sont rarement abordés spontanément par le patient et peu recherchés par les cliniciens. Ils sont pourtant responsables d'une baisse de la qualité de vie ainsi que d'une diminution de l'observance au traitement, entraînant un risque de rechute ou d'aggravation de la pathologie mentale traitée. Ceci est d'autant plus problématique que les antidépresseurs sont souvent nécessaires à long terme et que la rémission spontanée de ces manifestations indésirables est faible. La prévention, la recherche et la gestion des effets secondaires sexuels sont donc des enjeux importants dans la prise en charge de patients traités par antidépresseurs.

[The neuroplastic effects of electroconvulsive therapy]. / Les effets neuroplastiques de la sismothérapie.

Major depressive disorder is an important cause of disability around the world, with a tremendous psychological burden and extensive socioeconomic consequences. Whilst both psychotherapy and psychopharmacology are effective in treating a depressive episode, often there is a delay of several weeks between the start of treatment and the first beneficial effects. More importantly, approximately 30 % of patients do not remit, even after several treatment attempts. As the oldest biological treatment in psychiatry that is still available, electroconvulsive therapy (ECT) remains the most potent of antidepressant interventions, today achieving a staggering 70-80 % response and a 50-60 % remission rate. In treatment-resistant patients, response rates are even as high as 50 %-70 %. Despite its effectiveness, the neurobiological mechanisms of ECT remain unclear. A large body of research suggests that ECT induces widespread changes in both brain structure and function. A key factor behind these powerful therapeutic properties appears to be the important neuroplastic effects of this treatment. This review of the literature will discuss the importance of neuroplasticity in the pathophysiology of depression and then bring up the neuroplastic effects of ECT.

Le trouble dépressif majeur est une cause importante d'invalidité dans le monde, avec des conséquences psychologiques et socio-économiques notables. Bien qu'un épisode dépressif soit généralement traité par différentes formes de psychothérapies ou de pharmacothérapies, il y a souvent un délai de plusieurs semaines entre le début de ces traitements et leurs premiers effets bénéfiques. Plus important encore, environ 30 % des patients n'entrent pas en rémission, même après plusieurs tentatives de traitement. L'électroconvulsivothérapie (ECT) reste la plus puissante des interventions antidépressives, atteignant une réponse de 70 à 80 % et un taux de rémission de 50 à 60 %. Chez les patients résistant au traitement, des taux de réponse de 50 à 70 % sont atteints. Malgré son efficacité, les mécanismes neurobiologiques de l'ECT restent flous. Un grand nombre de recherches suggère que l'ECT induit des changements généralisés à la fois dans la structure et le fonctionnement du cerveau. L'un des facteurs clé derrière ces puissantes propriétés thérapeutiques semble être les importants effets neuroplastiques de ce traitement. Dans cette revue de la littérature, nous aborderons l'importance de la neuroplasticité dans la physiopathologie de la dépression pour, ensuite, aborder les effets neuroplastiques de l'ECT.

Air-photonics terahertz platform with versatile micro-controller based interface and data acquisition.

We present a terahertz (THz) platform employing air plasma produced by an ultrashort two-color laser pulse as a broadband THz source and air biased coherent detection (ABCD) of the THz field. In contrast to previous studies, a simple peak detector connected to a micro-controller board acquires the ABCD-signal coming from the avalanche photodiode. Numerical simulations of the whole setup yield temporal and spectral profiles of the terahertz electric field in both source and detection area. The latter ones are in excellent agreement with our measurements, confirming THz electric fields with peak amplitude in the MV/cm range. We further illustrate the capabilities of the platform by performing THz spectroscopy of water vapor and a polystyrene reference sample.

Spectral filtering of high-order harmonics via optics-free focusing.

Controlling the wavefront of an extreme ultraviolet (XUV) high-order harmonic beam during the generation process offers the capability of modifying the beam properties without resorting to any XUV optics. By characterizing the XUV intensity profile and wavefront, we quantitatively retrieve both the size and the position of the waist of each harmonic generated in an argon jet. We show that optics-free focusing can occur under specific generating conditions leading to XUV focii of micrometer size. We also demonstrate that each focus is located at distinct longitudinal positions. Using this remarkable XUV wavefront control combined with near focus spatial selection, we experimentally demonstrate efficient and adjustable spectral filtering of the XUV beam, along with a strong rejection of the fundamental beam, without using any XUV optics. The experimental results are compared with simulations providing the impact of the filtering on the temporal profile of the XUV field. It shows that the attosecond structure is preserved and that the beam is more homogeneous after the filtering, thereby reducing the longitudinal focii shift. This is a major step to achieve high XUV intensity and probing ultrafast processes with an improved resolution.

High-order parametric generation of coherent XUV radiation.

Extreme ultraviolet (XUV) radiation finds numerous applications in spectroscopy. When the XUV light is generated via high-order harmonic generation (HHG), it may be produced in the form of attosecond pulses, allowing access to unprecedented ultrafast phenomena. However, the HHG efficiency remains limited. Here we present an observation of a new regime of coherent XUV emission which has a potential to provide higher XUV intensity, vital for applications. We explain the process by high-order parametric generation, involving the combined emission of THz and XUV photons, where the phase matching is very robust against ionization. This introduces a way to use higher-energy driving pulses, thus generating more XUV photons.

[Neuropsychiatric complications of COVID-19]. / Complications neuropsychiatriques de la COVID-19.

The COVID-19 coronavirus pandemic is a major stressor in the population, due to our physical vulnerability, our fear of dying, the major upheaval of our life habits linked to confinement and the difficulty of projecting us into the future. Caregivers themselves are more exposed than ever to burnout and post-traumatic stress disorder. However, other neuropsychiatric complications related directly to the viral infection of the central nervous system or secondary to the immune storm are to be feared in the short term (encephalopathies, myopathies, anosmia, ageusia) but also in the medium and long term (depression, anxiety disorders, schizophrenia, post-traumatic stress disorder, Guillain-Barre syndrome, Parkinson's disease or neurodegenerative conditions). The pathophysiological mechanisms, in particular immune mechanisms at the origin of the central nervous system damage, will be discussed. A strict longitudinal monitoring of these neuropsychiatric complications across all ages of the population is therefore necessary from now.

La pandémie à coronavirus COVID-19 constitue un facteur de stress majeur dans la population, de par la confrontation à notre vulnérabilité sur le plan physique, notre peur de mourir, le bousculement important de nos habitudes de vie liées au confinement et la difficulté de nous projeter dans le futur. Les soignants eux-mêmes sont, plus que jamais, exposés au burnout et au stress post-traumatique. Cependant, d'autres complications neuropsychiatriques en lien direct avec l'infection virale du système nerveux central ou secondaires à la tempête immunitaire sont à craindre à court terme (encéphalopathies, myopathies, anosmie, agueusie), mais aussi à moyen et long termes (dépression, troubles anxieux, schizophrénie, syndrome de stress post-traumatique, syndrome de Guillain-Barré, maladie de Parkinson ou affections neurodégénératives). Les mécanismes physiopathologiques, en particulier immunitaires, à l'origine de l'atteinte du système nerveux central, seront discutés. Un monitoring strict longitudinal de ces complications.

Absolute gas density profiling in high-order harmonic generation: erratum.

In this erratum, we correct two numerical errors due to conversion mistakes from our previous published manuscript [Opt. Express 26, 6001 (2018)]. In the original manuscript, the two errors compensated each other such that the conclusions remain perfectly unchanged.

Optics-less focusing of XUV high-order harmonics.

By experimentally studying high-order harmonic beams generated in gases, we show how the spatial characteristics of these ultrashort extreme-ultraviolet (XUV) beams can be finely controlled when a single fundamental beam generates harmonics in a thin gas medium. We demonstrate that these XUV beams can be emitted as converging beams and thereby get focused after generation. We study this optics-less focusing using a spatially chirped beam that acts as a probe located inside the harmonic generation medium. We analyze the XUV beam evolution with an analytical model and obtain very good agreement with experimental measurements. The XUV foci sizes and positions vary strongly with the harmonic order, and the XUV waist can be located at arbitrarily large distances from the generating medium. We discuss how intense XUV fields can be obtained with optics-less focusing and how the order-dependent XUV beam characteristics are compatible with broadband XUV irradiation and attosecond science.

Electron correlation driven non-adiabatic relaxation in molecules excited by an ultrashort extreme ultraviolet pulse.

The many-body quantum nature of molecules determines their static and dynamic properties, but remains the main obstacle in their accurate description. Ultrashort extreme ultraviolet pulses offer a means to reveal molecular dynamics at ultrashort timescales. Here, we report the use of time-resolved electron-momentum imaging combined with extreme ultraviolet attosecond pulses to study highly excited organic molecules. We measure relaxation timescales that increase with the state energy. High-level quantum calculations show these dynamics are intrinsic to the time-dependent many-body molecular wavefunction, in which multi-electronic and non-Born-Oppenheimer effects are fully entangled. Hints of coherent vibronic dynamics, which persist despite the molecular complexity and high-energy excitation, are also observed. These results offer opportunities to understand the molecular dynamics of highly excited species involved in radiation damage and astrochemistry, and the role of quantum mechanical effects in these contexts.

[Berger's disease associated to an adalimumab-treated rheumatoid arthritis]. / Maladie de Berger au cours d'une Polyarthrite Rhumatoïde traitée par Adalimumab.

Berger's disease is characterized by deposits of immunoglobulin A in the glomerular mesangium. We report a case of a patient who was treated by adalimumab for a rheumatoid arthritis (RA). The patient is 45 years old and is treated for RA since 1996. Adalimumab was started after the failure of several treatments. Biological and clinical response to adalimumab were excellent. A nephrotic syndrome was diagnosed during the patient follow-up. Adalimumab was stopped since it was suspected to be responsible of these symptoms. Berger's disease was diagnosed thanks to a renal biopsy. The nephrotic syndrome was treated with corticosteroids, then tocilizumab was used to treat RA. TNF-alpha inhibitors are well known for inducing kidneys' adverse reactions (ADR). Usually, they appear shortly after the beginning of a treatment. Adalimumab has already been described in studies for inducing similar kidneys' adverse drug reactions. These ADR are often associated with systemic disease outbreak. It is difficult to assert that adalimumab or RA was responsible of the ADR that we noticed in our patient. It is usually admitted that these ADR are uncommon when the RA is controlled.

Absolute gas density profiling in high-order harmonic generation.

We propose and implement a method to determine the absolute density profile of a gas jet producing high-order harmonics. By measuring the transverse profile of the fluorescence emitted by the plasma, we retrieve the local density in the gas jet. We use this technique during the optimization of the high-harmonics of 515 nm, 10 µJ, 130 fs pulses at 500 kHz and find that we can generate in absorption-limited conditions.

Impaired facial and vocal emotion decoding in schizophrenia is underpinned by basic perceptivo-motor deficits.

INTRODUCTION: Emotional decoding impairments have been largely demonstrated in schizophrenia for facial and prosodic stimuli, when presented separately. Nevertheless, the exploration of crossmodal integration has been far less considered, despite its omnipresence in daily social interactions. Moreover, the role played by basic visuo-motor impairments in unimodal and crossmodal decoding remains unexplored. METHODS: Thirty-two patients were compared with 32 matched controls in an emotional decoding task including unimodal (visual and auditory) and crossmodal (congruent and incongruent) conditions. A control perceptive task was also conducted to take potential low-level perceptual deficits into account. RESULTS: Schizoprenic patients presented lower performance and higher reaction times for both unimodal tasks (visual and auditory) and crossmodal conditions. Moreover, reaction times for the visuo-perceptive task were also significantly longer for patients compared to controls. CONCLUSIONS: The consistency of the results across unimodal and crossmodal tasks suggests a globalised emotional impairment in schizophrenia, independent of the sensorial modality and crossmodal nature of the stimuli. Centrally, given the results in the visuo-perceptive task, the impairments observed for emotional recognition appears at least partly explained by primary cognitive deficits, namely reduced processing speed.

Influence of long-range Coulomb interaction in velocity map imaging.

The standard velocity-map imaging (VMI) analysis relies on the simple approximation that the residual Coulomb field experienced by the photoelectron ejected from a neutral or ion system may be neglected. Under this almost universal approximation, the photoelectrons follow ballistic (parabolic) trajectories in the externally applied electric field, and the recorded image may be considered as a 2D projection of the initial photoelectron velocity distribution. There are, however, several circumstances where this approximation is not justified and the influence of long-range forces must absolutely be taken into account for the interpretation and analysis of the recorded images. The aim of this paper is to illustrate this influence by discussing two different situations involving isolated atoms or molecules where the analysis of experimental images cannot be performed without considering long-range Coulomb interactions. The first situation occurs when slow (meV) photoelectrons are photoionized from a neutral system and strongly interact with the attractive Coulomb potential of the residual ion. The result of this interaction is the formation of a more complex structure in the image, as well as the appearance of an intense glory at the center of the image. The second situation, observed also at low energy, occurs in the photodetachment from a multiply charged anion and it is characterized by the presence of a long-range repulsive potential. Then, while the standard VMI approximation is still valid, the very specific features exhibited by the recorded images can be explained only by taking into consideration tunnel detachment through the repulsive Coulomb barrier.

Nutritional status and height, weight and BMI centiles of school-aged children and adolescents of 6-18-years from Kinshasa (DRC).

BACKGROUND: The last study to establish centiles of main anthropometric measurements in Kinshasa was conducted over 60 years ago, which questions its current adequacy to describe or monitor growth in this population. AIM: To assess the nutritional status of school-aged children and adolescents and to estimate centile curves of height, weight and body mass index (BMI). SUBJECTS AND METHODS: A representative sample of 7541 school-aged children and adolescents (48% boys) aged 6-18 years was measured between 2010-2013. Smooth centiles of height, weight and BMI-for-age were estimated with the LMS method and compared with the WHO 2007 reference. Nutritional status was assessed by comparing measurements of height and BMI against the appropriate WHO cut-offs. RESULTS: Compared to the WHO reference, percentiles of height and BMI were generally lower. This difference was larger in boys than in girls and increased as they approached adolescence. The prevalence of short stature (< -2 SD) and thinness (< -2 SD) was higher in boys (9.8% and 12%) than in girls (3.4% and 6.1%), but the prevalence of overweight (> 1 SD) was higher in girls (8.6%) than in boys (4.5%). CONCLUSION: Children from Kinshasa fall below WHO centile references. This study established up-to-date centile curves for height, weight and BMI by age in children and adolescents. These reference curves describe the current status of these anthropometric markers and can be used as a basis for comparison in future studies.

Spectacular improvement in vitamin D status in elderly osteoporotic women: 8-year analysis of an osteoporotic population treated in a dedicated fracture liaison service.

UNLABELLED: In a population of postmenopausal women with a fragility fracture, we found a drastic reduction in the proportion of women with severe (<25 nmol/L) and moderate (25 to 75 nmol/L) hypovitaminosis D, especially from 2009 onwards. These results show that supplementation has been very widely integrated into current practice. INTRODUCTION: Vitamin D (25(OH)D) is essential for bone health. In institutionalised osteoporotic women, it reduces the risk of fragility fractures. Numerous articles suggesting the possibility of extraosseous effects have generated a growing number of publications and recommendations on more widespread administration, to limit the risks of moderate or severe hypovitaminosis D. We assessed the impact on clinical practice of these recommendations concerning 25(OH)D supplementation in elderly at-risk populations. METHODS: A total of 1486 postmenopausal osteoporotic women were seen in the context of a fracture liaison service (i.e. a rheumatology consultation following a peripheral fragility fracture), between May 2005 and December 2012. Of these, 1107 had a 25(OH)D assay (femur, n = 520; humerus, n = 207; wrist, n = 380). RESULTS: The average age of the total population was 76.7 ± 9.9 years, while for women with an available 25(OH)D assay, the average age was 75.1 ± 11.8 years. The average 25(OH)D (nmol/L) level was similar for the three fracture sites: femur, 30 ± 36.2; humerus, 27.5 ± 24; and wrist, 31 ± 26. A drastic reduction in the proportion of women with severe (<25 nmol/L) and moderate (25 to 75 nmol/L) hypovitaminosis D was observed, especially from 2009 onwards, with a mean prevalence of 69 and 30 % respectively before that year and 35 and 52 % thereafter. Conversely, the proportion of women with 25(OH)D at the threshold value of 75 nmol/L increased from 1.2 to 24 %. Overall, mean serum 25(OH)D levels were significantly higher when comparing the two periods 2005-2008 and 2009-1012 (17.6 ± 14.6 and 48.4 ± 39.2 nmol/L, respectively; p < 0.0001). CONCLUSION: These results show that supplementation has been very widely integrated into current practice. We can expect it to yield beneficial effects in osseous and extraosseous terms in osteoporotic women, particularly the very elderly.

Spatio-spectral structures in high-order harmonic beams generated with Terawatt 10-fs pulses.

A large international effort is nowadays devoted to increase the energy of the extreme ultraviolet pulses by using high-peak power ultrashort fundamental pulses (Terawatt level). Using such fundamental pulses brings specific constraints that need to be addressed. Here we study high-order harmonic generation in gases with 10 fs pulses at Terawatt peak power and demonstrate that extreme ultraviolet beams can be highly structured and complex in various conditions. We use a single-shot spatially resolved spectral detection and demonstrate direct observation of the spatio-temporal coupling occurring in the generating medium. Clear and reproducible complex spatio-spectral structures are observed in the far field. Similar structures are reproduced with simulations and we show that they are intimately associated to the high nonlinearity of high-order harmonic generation. Those findings are of prime importance for the generation of high-energy attosecond pulses and reveal important issues for their applications.

[Clinical course of post-stroke depression in Kinshasa]. / Évolution clinique de la dépression post-accident vasculaire cérébral à Kinshasa.

OBJECTIVES: To describe the evolution of the clinical profile of post-stroke depression over a period of one year and to determine factors associated with changes in post-stroke depression. METHODS: Prospective cohort study with a follow-up of 1year including 30 consecutive eligible patients. The severity of depression was assessed with the patient health questionnaire (PHQ9). RESULTS: The mean age was 55.87±12.67years. Seventy percent of patients were men. The two assessments for neurological status, perceived health status and test results of attention were not statistically different. The rate of depressive symptoms was 26.67% in 2011 and 20% in 2012. Disability and apathy were significantly improved. The average for disability increased from 2.77±1.19 to 2.46±2.19 (P=0.002). From 66.7% in 2011, the proportion of patients able to walk without assistance rose to 93.3% in 2012 (P=0.03). In addition, the proportion of patients apathetic decreased from 43.3% to 13.3% (P=0.01). Greater age, female sex, sleep disorders and post-stroke apathy remained associated with DPAVC between the two assessments, with an increase in the strength of the association for apathy. CONCLUSIONS: The frequency of post-stroke depression is high and remains stable over time. Disability is the clinical feature that evolved more favorably. The association with apathy, present at the beginning, of the study was strengthened one year later.

Short pulse carrier-envelope phase absolute single-shot measurement by photoionization of gases with a guided laser beam.

We present an all optical approach to measure the value of the carrier-envelope phase (CEP) of a short intense laser pulse. This method relies on photo-ionization of gases with a guided laser beam. This approach that provides the absolute value of the CEP, is compatible with single shot characterization, is scalable in wavelength, does not suffer from bandwidth limitation and is largely intensity independent. It has also the potential to provide a full characterization of the pulse profile via high order autocorrelation on a single shot basis.

[Clinical stakes when switching from one antipsychotic to another]. / Enjeux cliniques du passage d'un antipsychotique à l'autre.

Switching antipsychotics is more and more common in our clinical practice. Several reasons can explain this observation. We have more and more antipsychotics available on the market with different receptor binding profiles and also different tolerability issues. Usually, the reasons of the switch are the following: insufficient efficacy or problems of tolerance (weight gain, metabolic disorders, extrapyramidal symptoms, hyperprolactinemia, sedation, sexual dysfunction). So that the switch takes place without complications, it is essential for the clinician to have full knowledge of both the receptor binding profiles of the antipsychotics in question and their half-life. The clinician has to expect a dopaminergic rebound when the introduced antipsychotic has a lesser affinity for the dopaminergic D2 receptor than that which is withdrawn or if it is a partial agonist with a particularly long half-life. On the other hand, a histaminergic or cholinergic rebound can be expected if the new antipsychotic has a lesser affinity for these two receptors. In all these scenarios, a "plateau" switch will often be recommended. Now, if a faster switch is imperative, various medication strategies exist to try to decrease the impact of the rebound effects.

Inhomogeneous high harmonic generation in krypton clusters.

High order harmonic generation from clusters is a controversial topic: conflicting theories exist, with different explanations for similar experimental observations. From an experimental point of view, separating the contributions from monomers and clusters is challenging. By performing a spectrally and spatially resolved study in a controlled mixture of clusters and monomers, we are able to isolate a region of the spectrum where the emission purely originates from clusters. Surprisingly, the emission from clusters is depolarized, which is the signature of statistical inhomogeneous emission from a low-density source. The harmonic response to laser ellipticity shows that this generation is produced by a new recollisional mechanism, which opens the way to future theoretical studies.