[Pulmonary function test: The testing of children]. / Exploration fonctionnelle respiratoire : explorer l'enfant.

In paediatrics, the pulmonary function test (PFT) is most often performed to support the diagnosis or in follow-up of asthma patients. Whatever the pathology responsible for respiratory symptoms and/or functional impairment, repeated PFTs make it possible to establish a prognosis (pulmonary function trajectories…) and to orient preventive interventions. PFT can be performed routinely from the age of three years, provided that the following requirements are met: suitable techniques and equipment, staff trained to apply the techniques and to receive young children, reference values for each technique indicating the limits of normal values and of between-test significant variation. From the age of three, children can be subjected to tidal breathing measurement of: resistance of the respiratory system (oscillometry, Rrs; airflow interruption, Rint) or of airways specific resistance (sRaw) and functional residual capacity (by applying a dilution technique). With maturity, the child will become capable of mobilizing his or her slow vital capacity to measure total lung capacity (TLC), once again by applying a dilution technique, then later by breathing against a closed shutter (plethysmography TLC and Raw). Finally, the child will be able to carry out forced expiration (forced spirometry) along with all of the other PFTs. It is important to take into account the paediatric adaptations specified in the international recommendations regarding the performance, reproducibility and quality of PFTs targeting this population.

[The place of gentleness in joint perinatal psychiatric care]. / Place de la douceur dans les soins conjoints de psychiatrie périnatale.

The complexity and specificity of joint care in perinatal psychiatry call for a rethinking of gentleness. Allowing oneself to make it the object of reflection in its own right means summoning up an essential dimension of welcoming, carrying and meeting the other, which are at the heart of support. Articulating adversity and fragility, creativity and destructiveness, gentleness is a quality, a texture on which a care team can rely from both a clinical and an institutional point of view.

The Beneficial, Formative Role of Lifetime Exposures across Cognitive Domains in Barbados Using Data from the SABE Study.

This study tested the hypothesis that within older Barbadian adults, sex, education, and occupation type lessen age-related cognitive decline. The analyses used a cross-sectional data set from 1325 people collected in the 2006 SABE Study (Health, Well-being, and Aging). Cognition was assessed as scores in each subdomain of the Mini-Mental State Exam. The loss of a single point in each subdomain was predicted by sex, years of education, job type, and their interactions with age. Results demonstrated that age and protective factors affect each cognitive domain differently. High education combined with mentally complex employment helped maintain cognitive performance in later life. Beneficial lifetime exposures are additive, providing combined benefits. Findings provide insight into public policy aiming to minimize the number of adults with cognitive decline and dementia in Barbados and the Caribbean.

Erectile function preservation after radiotherapy using a dose-optimization approach on sexual structures for localized prostate cancer.

PURPOSE: Erectile function preservation is an important quality of life factor in patients treated for prostate cancer. A dose-optimization approach on sexual structures was developed and evaluated to limit erectile dysfunction after radiotherapy. MATERIALS AND METHODS: Twenty-three men with localized prostate cancer and no erectile dysfunction were enrolled in the study. All patients received a prescription dose between 76 and 78Gy. Computed tomography/magnetic resonance image registration was used to delineate the prostatic volume and the sexual structures: internal pudendal arteries (IPA), penile bulb and corpus cavernosum. Erectile function was evaluated using the 5-items International Index of Erectile Function (IIEF-5) score every 6 months during the 2 years after radiotherapy and once a year afterwards. No erectile dysfunction, mild erectile dysfunction and severe erectile dysfunction were defined if the IIEF-5 scores were 20-25, 17-19 and < 17, respectively. RESULTS: The mean follow-up was 4.5 years. The mean age of the patients was 66.3 years. At 2 years, 67% of the patients had no erectile dysfunction, 11% had mild erectile dysfunction and 22% had severe erectile dysfunction. No significant difference was found between the patients with and without erectile dysfunction (IIEF-5≥20 and IIEF-5<20, respectively) for any of the parameters: dosimetric values (internal pudendal arteries, penile bulb, corpus cavernosum), age, comorbidity and smoking status. The biochemical-relapse free survival was 100% at 2 years. CONCLUSION: This approach with dose-optimization on sexual structures for localized prostate cancer found excellent results on erectile function preservation after radiotherapy, with 78% of the patients with no or mild erectile dysfunction at 2 years.

Offline and online parental mentalizing in mothers with symptoms of postpartum depression: Examining the association between self-reported parental reflective functioning and interactional mind-mindedness.

Mentalizing is, to a certain extent, considered context specific. However, research on the association between parents' abilities to reflect upon their infant's mental states outside social interaction (offline) versus during ongoing parent-infant interaction (online) is currently limited. This study investigated the association between self-reported offline and online mentalizing in a sample of primarily ethnically Danish mothers (N = 142), with symptoms of postpartum depression, and their 1-11-month-old infants. Offline mentalizing was assessed with the Parental Reflective Functioning Questionnaire-Infant Version (PRFQ-I) and online mentalizing was assessed with interactional mind-mindedness. Ordinal logistic regressions showed that a higher score on the PRFQ-I prementalizing subscale was negatively related to number of overall mind-related comments and appropriate mind-related comments produced by mothers during interaction with their infant. Our results indicate partial overlaps between self-reported parental reflective functioning and mind-mindedness, that is, that particularly offline maladaptive mentalizing is associated with lower levels of mentalizing during interaction in mothers with symptoms of depression. Post-hoc examination of the interaction effect of postpartum depression showed that this association was only evident in mothers with medium to high levels of depression. Findings and implications are discussed.

Se considera, hasta cierto punto, que la mentalización se corresponde con un contexto específico. Sin embargo, la investigación acerca de la asociación entre las habilidades de los padres de reflexionar sobre los estados mentales de sus infantes fuera de la interacción social (no conectada a la internet / fuera de línea) versus la continua interacción progenitor­infante (en línea) es actualmente limitada. Este estudio investigó la asociación entre la auto­reportada mentalización tanto fuera de línea como en línea en un grupo muestra primariamente de madres étnicamente danesas (N = 142), con síntomas de depresión posterior al parto, y sus infantes de 1 a 11 meses de edad. La mentalización fuera de línea se evaluó por medio del Cuestionario del Funcionamiento con Reflexión del Progenitor ­ Versión del Infante (PRFQ­I) y la mentalización en línea se evaluó con el sistema de codificación de Conciencia Mental. La regresión logística ordinal mostró que un puntaje más alto en la sub­escala de pre­mentalización del PRFQ­I se asoció negativamente con el número en general de comentarios relacionados con la mente y de apropiados comentarios relacionados con la mente producidos por las madres durante la interacción con sus infantes. Nuestros resultados indican que hay superposiciones coincidentes parciales entre el funcionamiento con reflexión auto­reportado por el progenitor y la conciencia mental, v.g. que particularmente la mentalización fuera de línea inadaptada se asocia con una conciencia mental en línea menos óptima en madres con síntomas de depresión. Las posteriores examinaciones que el efecto de la interacción de la Escala de Depresión Postnatal de Edimburgo (EPDS) tiene sobre la asociación mostraron que esta característica sólo fue evidente en madres con niveles medianos a altos de depresión. Se discuten los resultados y las implicaciones.

La mentalisation est, dans une certaine mesure, considérée comme étant spécifique au contexte. Cependant les recherches sur le lien entre les capacités des parents à réfléchir sur les états mentaux de leur bébé en dehors de l'interaction sociale (hors connexion) par rapport à l'interaction continue parent­bébé (en ligne) sont en ce moment limitées. Cette étude s'est penchée sur le lien entre la mentalisation auto­déclarée hors connexion et en ligne chez un échantillon de mères en grande partie danoises (N = 142), avec des symptômes de dépression postpartum et leurs bébés âgés de 1 à 11 mois. La mentalisation hors connexion a été évaluée au moyen du Questionnaire de la Fonction Réflexive Parentale ­ Version Nourrisson (en anglais PRFQ­I) et la mentalisation en ligne a été évaluée au moyen du système de codage esprit­sensibilité. Des régressions logistiques ordinales ont montré qu'un score plus élevé à la sous­échelle PRFQ­I était lié de manière négative au nombre de commentaires généraux liés à l'esprit et à des commentaires liés à l'esprit appropriés produits par les mères durant l'interaction avec leur bébé. Nos résultats indiquent des chevauchement spartiels entre la fonction réflexive parentale auto­rapportée et la sensibilité, c'est­à­dire que la mentalisation inadaptée en particulier hors­connexion est liée à une sensibilité moins qu'optimale chez les mères avec des symptômes de dépression. L'examen a posteriori des effets de l'interaction de l'EPDS sur ce lien a montré que cela n'était que vrai chez les mères avec des niveaux de dépression de moyens à élevés. Les résultats et implications sont discutés.

Unhinged: A Prospective Perspective on Being Unsafe1.

Given the unprecedented events unfolding around the globe over the past four years, psychoanalytic communities near and far have sought to ask and ventured to answer the question: What does psychoanalysis have to offer individuals, and the collective, as a way of seeing and being with the reality of what is? Taking up these questions in such a time as this, feels, perhaps inevitably, unsafe. Sometimes it can feel as if there is a silent and unspoken mandate to ensure safety at all costs when we seek to find a spirit of the depth's response to the spirit of the times. I propose that the work of psychoanalysis is grounded in nothing but the journey through that which is unsafe. This article will take up Ann Ulanov's notion that one's own evil is the hinge door into collective and archetypal evil. To become unhinged means to risk well-formulated understandings, theories, and modalities about being and becoming for the other and instead to allow the other to penetrate that which is unknown in ourselves, upending our well-formed theories and pressing us to take up our own lives in new and unpredictable ways.

Compte tenu des événements sans précédent qui se sont déroulés dans le monde entier au cours des quatre dernières années, les communautés psychanalytiques proches et lointaines ont cherché à poser la question suivante et à y proposer des réponses: qu'est­ce que la psychanalyse peut offrir aux individus, et au collectif, comme moyen de voir et d'être avec la réalité de ce qui est ? Aborder ces questions dans un moment comme celui­ci nous fait nous sentir en danger, et c'est peut­être inévitable. Parfois, on peut avoir le sentiment qu'il y a un décret silencieux et tacite d'assurer la sécurité à tout prix lorsque nous cherchons à trouver une réponse de l'esprit des profondeurs à l'esprit du temps. Je propose que le travail de la psychanalyse n'est fondé sur rien d'autre que le voyage à travers ce qui est dangereux, risqué. C'est, en effet, ce qu'implique la recherche d'une conversation active et vivante avec l'esprit des profondeurs et c'est ce qui distingue le travail de thérapie du travail de psychanalyse. Si nous nous enfermons dans des notions de sécurité, nous resterons liés à des notions similaires d'anonymat analytique et d'innocence, restant inconscients de notre propre implication dans les horreurs qui continuent d'aliéner, d'étouffer et d'isoler ceux qui sont en marge. Cette présentation reprendra la conception d'Ann Ulanov selon laquelle le mal d'une personne est la porte charnière du mal collectif et archétypal. Notre travail, individuellement et collectivement, est de descendre dans ce territoire dangereux à l'intérieur de nous­mêmes pour voir ce qui s'y est passé et ce qui reste à vivre dans les zones d'ombre. Devenir déséquilibré signifie mettre en doute des compréhensions, des théories et des modalités bien formulées sur l'être et le devenir pour l'autre et, à la place, permettre à l'autre de pénétrer ce qui est inconnu en nous­mêmes, bouleversant nos théories bien formées et nous poussant à prendre notre propre vie en main d'une manière nouvelle et imprévisible. En ce sens, la psychanalyse est intrinsèquement une forme d'activisme intérieur et extérieur. Ce qui est proposé ici est un regard sur la façon dont la psychanalyse, déséquilibrée, se déplace au­delà des murs sécurisants et au­delà des murs de la salle de consultation vers le monde au sens large.

Dados los acontecimientos sin precedentes que han tenido lugar en todo el mundo en los últimos cuatro años, las comunidades psicoanalíticas cercanas y lejanas han tratado de preguntarse y han intentado responder a la pregunta: ¿qué tiene el psicoanálisis que ofrecer a los individuos, y al colectivo, en términos de ver y estar con la realidad de lo que acontece? Abordar estas cuestiones en un momento como el actual puede resultar inevitablemente inseguro. A veces puede dar la sensación de que existe un mandato silencioso y tácito de garantizar la seguridad a toda costa cuando tratamos de encontrar una respuesta del espíritu de las profundidades al espíritu de los tiempos. Propongo que el trabajo del psicoanálisis no se basa en otra cosa que en el viaje a través de lo que es inseguro. Esto, de hecho, es lo que implica buscar una conversación activa y viva con el espíritu de las profundidades y es lo que distingue el trabajo de la terapia del trabajo del psicoanálisis. Si nos encerráramos en las nociones de seguridad, seguiríamos limitados por nociones similares de neutralidad analítica e inocencia, permaneciendo inconscientes de nuestra propia implicancia en los horrores que continúan ajenos, encerrando y aislando a aquellos que se encuentran en los márgenes. Esta presentación retomará la noción de Ann Ulanov de que el mal propio es la puerta de entrada al mal colectivo y arquetipal. Nuestro trabajo individual y colectivo es descender a este territorio inseguro dentro de nosotros mismos para ver lo que ocurrió allí y lo que permanece viviendo en las sombras. Perturbarse significa arriesgar comprensiones, teorías y modalidades bien formuladas sobre el ser y el devenir para el otro y, en su lugar, permitir que el otro penetre en lo que es desconocido en nosotros mismos, trastornando nuestras teorías bien formadas y presionándonos para que asumamos nuestras propias vidas de maneras nuevas e impredecibles. De este modo, el psicoanálisis es inherentemente una forma de activismo interior y exterior. Lo que se ofrece es una mirada sobre cómo el psicoanálisis, perturbado, traspasa los muros de la seguridad y va más allá de las paredes del consultorio analítico para adentrarse en el mundo en general.

War: Mentalization and Totalitarian State of Mind.

For most residents of Europe, war is a new experience in which they find themselves both as witnesses and participants. In this paper the war in Ukraine serves as an illustration and case example. Like any unfamiliar experience, war elicits profound emotional responses which can be so overwhelming that an individual may be unable to fully process them and to create mental representations of the reality of war. When the psyche becomes entrapped in an unprocessed state, without the capacity to derive meaning from it, this results in the "fossilization" of the psyche akin to what McGinley and Segal describes as a totalitarian state of mind. Subjectivity and individual differences come under collective or personal attack, or both. This state of being prioritizes the needs of the collective psyche over the individual psyche. The image of Gorgon Medusa, who transformed living people into "fossilized" ones, is presented as a metaphor of total identification with the collective dimension. In contrast, the psyche can reveal a creative approach to resolving war-induced trauma. This is depicted in the concept of the Alchemical Stone and its creation, which symbolizes a harmonious connection between the external and internal realms, the subjective and objective experiences, and the real and the imaginal dimension.

Pour la plupart des habitants de l'Europe, la guerre est une nouvelle expérience dans laquelle ils se retrouvent à la fois témoins et participants. Dans cet article, la guerre en Ukraine sert d'illustration et de cas exemplaire. Comme toute expérience qui sort de l'ordinaire, la guerre suscite des réactions émotionnelles profondes qui peuvent être si accablantes qu'un individu peut se trouver incapable de les traiter pleinement et de créer des représentations mentales de la réalité de la guerre. Lorsque la psyché se retrouve piégée dans un état qu'elle ne peut pas traiter, sans la capacité d'en tirer un sens, il en résulte une « fossilisation ¼ de la psyché, semblable à ce que McGinley et Segal a décrit comme un état d'esprit totalitaire. La subjectivité et les différences individuelles font l'objet d'attaques collectives ou personnelles, ou des deux. Cet état d'être donne la priorité aux besoins de la psyché collective plutôt qu'à la psyché individuelle. L'image de la Gorgone Méduse, qui a transformé des êtres vivants en êtres «fossilisés¼, est présentée comme une métaphore de l'identification totale à la dimension collective. En revanche, la psyché peut révéler une approche créative pour résoudre les traumatismes induits par la guerre. Ceci est représenté par le concept de la Pierre Alchimique et de sa création, qui symbolise un lien harmonieux entre les royaumes extérieur et intérieur, les expériences subjectives et objectives, et les dimensions réelles et imaginales.

Para la mayoría de los habitantes de Europa, la guerra es una experiencia nueva en la que se encuentran tanto como testigos y como participantes. En este artículo, la guerra en Ucrania sirve como ilustración y ejemplo de caso. Como cualquier experiencia desconocida, la guerra provoca profundas respuestas emocionales que pueden ser tan abrumadoras que un individuo puede ser incapaz de procesarlas completamente y de crear representaciones mentales de la realidad de la guerra. Cuando la psique queda atrapada en un estado, sin posibilidad de elaborar y sin la capacidad para hallarle un sentido, se produce una "fosilización" de la psique similar a lo que McGinley Segal describe como un estado mental Totalitario. La subjetividad y las diferencias individuales son objeto de ataques colectivos o personales, o ambos. Este estado de ánimo prioriza las necesidades de la psique colectiva sobre la individual. La imagen de la Gorgona Medusa, que transformó a las personas vivas en "fosilizadas", se presenta como una metáfora de la identificación total con la dimensión colectiva. Por el contrario, la psique puede revelar un enfoque creativo para resolver el trauma inducido por la guerra. Esto se representa en el concepto de la Piedra Alquímica y su creación, que simboliza una conexión armoniosa entre los reinos externo e interno, las experiencias subjetivas y objetivas, y las dimensiones real e imaginal.

[The kidney, its anatomy and main functions]. / Le rein, son anatomie et ses grandes fonctions.

The kidney performs several major functions: it eliminates toxins produced by cellular or xenobiotic metabolism, regulates the homeostasis of the internal environment and plays a hormonal role, producing erythropoietin, calcitriol and renin. Maintaining the body's homeostasis (hydric, ionic [sodium, potassium, calcium, phosphorus, etc.] or acid-base balance) requires the successive action of plasma filtration, followed by reabsorption/secretion mechanisms, which take place in the various portions of the kidney's functional unit known as the nephron. The initial part of the nephron, the glomerulus, is the site of filtration, while the tubule, which collects the glomerular filtrate, is the site of reabsorption/secretion, leading to the composition of the final urine. It's important to understand how these different structures work, before tackling the various disorders that can affect the kidney.

[Obstetrical outcome of renal transplant patients followed in a type III maternity hospital. Retrospective study from 2000 to 2020]. / Devenir obstétrical des patientes transplantées rénales suivies dans une maternité de type III. Étude rétrospective de 2000 à 2020.

AIM: To describe pregnancy outcome of kidney transplant patients till 1 year postpartum. METHODS: This retrospective, monocentric study included 15 kidney transplant patients who presented 18 pregnancies, between January 2000 and January 2020. For each of them, we searched for possible obstetrical, fetal and renal complications and we evaluated renal function before, during and after pregnancy. RESULTS: The live birth rate was 84% (16/19) with an average gestational age at delivery of 37 weeks of gestation. The rate of prematurity was 50% (8/16), gestational diabetes was 16.6% (3/18) and preeclampsia was 27.7% (5/18). Cesarean section was performed in 61.1% (11/18) of cases including, 81.8% (9/11) unplanned surgery. The average birth weight was 2635 grams and 37.5% (6/16) of the newborn were small for gestational age. All patients had stable renal function before conception of pregnancy. We noticed two acute graft rejection during pregnancy with only one resulting in graft loss. Four patients had a reduced graft function in 12months of the postpartum. CONCLUSION: Risk of maternal, fetal and renal complications remained high in kidney transplant recipients. Pregnancy should be carefully planned in transplanted women associated with adequate follow-up according to clinical guidelines (normal renal function and blood pressure without proteinuria before pregnancy, no recent graft rejection, period of one year after transplant respected and no teratogenic treatment in the month before pregnancy).

Infant carrying: Associations with parental reflective functioning, parental bonding and parental responses to infant crying.

Infant carrying may have beneficial effects on the parent-infant relationship but only limited research has been conducted in this area. Therefore, the main aim of the current study was to investigate whether infant carrying is associated with parental reflective functioning, parental bonding, and parental (emotional) and behavioral responses to infant crying, key elements within the parent-infant relationship, promoting infant development. Parents reporting high levels (N = 389) of infant carrying (six times a week or daily) and parents reporting low levels (N = 128) of infant carrying (less than once a week or not at all) who participated in an online survey about the developing parent-infant relationship in Germany were included in the present study. Standardized questionnaires were used to assess parental reflective functioning, parental bonding impairments, and emotional responses to infant crying. Further insensitive (non-responsive and hostile) behaviors in response to infant crying were assessed. Parents with high levels of infant carrying showed better parental reflective functioning, lower parental bonding problems, less negative emotions, and less insensitive behaviors in response to infant crying.

Cargar al infante pudiera tener efectos beneficiosos para la relación progenitor­infante, pero sólo una limitada investigación se ha llevado a cabo en esta área. Por tanto, el objetivo principal del presente estudio fue investigar si cargar al infante se asocia con que el funcionamiento con reflexión del progenitor, los lazos de afectividad del progenitor, así como las respuestas de comportamiento (emocional) del progenitor al llanto del infante, elementos claves dentro de la relación progenitor­infante, promueven el desarrollo del infante. Se incluyó en el presente estudio a los progenitores que reportaron altos niveles (N=389) de llanto del infante (seis veces por semana o diariamente) y a los progenitores que reportaron bajos niveles (N=128) del llanto del infante (menos de una vez por semana o nunca), quienes participaron en una encuesta electrónica acerca de la relación progenitor­infante en desarrollo, en Alemania. Se usaron cuestionarios estandarizados para evaluar el funcionamiento con reflexión del progenitor, los impedimentos de lazos afectivos del progenitor, así como las respuestas emocionales al llanto del infante. Se evaluaron además comportamientos insensibles (sin respuesta afectiva y hostil) como respuesta al llanto del infante. Los progenitores con altos niveles de cargar al infante demostraron un mejor funcionamiento con reflexión del progenitor, más bajos problemas en cuanto a lazos de afectividad del progenitor, menos emociones negativas y menos comportamientos insensibles como respuesta al llanto del infante.

Porter un bébé peut avoir des effets bénéfiques sur la relation parent­bébé mais il n'existe que peu de recherches sur ce domaine. C'est pour cette raison que le but principal de cette étude était d'investiguer si le fait de porter un bébé est lié avec une fonction réflexive parentale, le lien parental et les réactions parentales (émotionnelles) et comportementales aux pleurs du bébé, des éléments clef au sein de la relation parent­bébé, promouvant le développement du bébé. Les parents faisant état de niveaux élevés (N=389) de portage du bébé (six fois par semaine ou tous les jours) et les parents faisant état de niveaux bas (N=128) de portage du bébé (moins d'une semaine ou pas du tout) qui ont participé à un questionnaire en ligne sur la relation parent­bébé se développant en Allemagne ont été inclus dans cette étude. Des questionnaires standardisés ont été utilisés afin d'évaluer la fonction réflexive parentale, les troubles du lien parental, et les réactions émotionnelles aux pleurs du bébé. D'autres comportement insensibles (non­réactifs et hostile) en réaction aux pleurs du bébé ont été évalués. Les parents avec des niveaux élevés de portage du bébé ont fait preuve d'une meilleure fonction réflexive parentale, de moins de problèmes de lien parental, de moins d'émotions négatives, et de moins de comportements insensibles en réaction aux pleurs du bébé.

Psychological Stress across the Lifespan and Cognitive Function among Older Adults: The Moderating Role of a Healthy Lifestyle.

This study aimed to (a) investigate the associations between indices of stress severity across the lifespan (early, middle, late life) and cognitive function among community-dwelling older adults, and (b) examine whether a healthy lifestyle composite score comprised of physical activity, healthy diet adherence, social engagement, sleep quality, and mindful relaxation moderates the associations between lifespan stress severity and cognitive function. Participants (n = 226, Mage = 68.2 ± 6.5, 68.1% female) completed questionnaires to measure stress and lifestyle behaviours, and three online neurocognitive tasks. No direct associations between stress severity and cognition were found. The healthy lifestyle composite score moderated the associations between early, midlife, and late-life stress severity and inhibitory control. Exploratory analyses suggest that this moderating effect may be sex-dependent. Despite study limitations and the need for additional research, findings provide preliminary support for the role of lifestyle behaviours in enhancing older adults' resilience to the effects of stress on cognitive health in a sex-specific manner.

Impact of pectus excavatum on pulmonary function and exercise capacity in patients treated with 3D custom-made silicone implants.

BACKGROUND: Pectus excavatum (PE) is the most common congenital chest wall deformity, whose cardiopulmonary consequences are controversial. PE surgery is in our experience usually performed for aesthetic reasons. OBJECTIVES: The aim of this study was to evaluate the impact of PE on respiratory function and exercise capacity in patients with PE before patient-specific silicone implant correction. METHODS: This monocentric prospective study conducted at Toulouse University Hospital included sixty patients scheduled for custom-made silicone implants correction. Respiratory function (pulmonary function tests (FPTs)) and exercise capacity (VO2 max) were measured before surgery. RESULTS: Before surgery, no (0/60) restrictive lung disease was detected, with a mean total lung capacity (TLC) of 98.5% of predicted value (IC 95%; 80.4-137). Median VO2 max (n=56) was normal (89% predicted), with no cardiac limitation. CONCLUSION: In this cohort, PE had no impact on respiratory function nor exercise capacity. In patients without cardiac or respiratory effects of PE, silicone implants should be considered the preferred approach as it adequately addressed patients' main complaint of low self-esteem.

Le globule rouge drépanocytaire : données fonctionnelles: The sickle red blood cell: functional data.

Sickle cell anemia is a genetic disorder that affects hemoglobin leading to the production of an abnormal hemoglobin, called HbS. HbS has the property to polymerize under deoxygenated conditions, causing a mechanical distortion of red blood cells; a phenomenon called sickling. These sickle red blood cells are more fragile and rigid, leading to chronic hemolytic anemia and painful vaso-occlusive crises, as well as chronic vascular complications that can affect many organs. The abnormal functional properties of these sickle red blood cells are responsible for a wide range of clinical expression of the disease. HbS polymerization can be influenced by many factors, such as the hydration state of the red blood cells or the affinity of hemoglobin for oxygen. Moreover, the rheological characteristics of red blood cells, including their deformability and aggregation properties, are associated with specific clinical phenotypes. The pro-inflammatory and pro-oxidant state, as well as the repeated polymerization of HbS, accelerate the senescence of sickle red blood cells, promoting the release of microparticles and contributing to vascular dysfunction. Patients' red blood cells also have molecular characteristics that promote their adhesion to the endothelium and other circulating cells, contributing to the onset of vascular complications. Massive intravascular hemolysis, due to increased erythrocyte fragility, is also responsible for chronic vascular complications. These different alterations are privileged therapeutic targets, leading to the emergence of new specific treatments. © 2023 Société nationale française de médecine interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

[The narcissistic envelope of the care team in times of crisis in psychiatry]. / L'enveloppe narcissique de l'équipe soignante par temps de crise en psychiatrie.

The narcissistic envelope plays a fundamental role for psychiatric care teams to whom it guarantees sufficient internal security, supporting their investment in the therapeutic relationship. The hospital crisis is undermining these teams. By promoting the denarcissization of the nursing staff, it increases their resistance and questions the future of the care team registered in a collective in psychiatry.

Estudio de la función materna y paterna en la constitución psíquica de un niño con discapacidad. Análisis de un caso clínico / Étude de la fonction maternelle et paternelle dans la constitution psychique d'un enfant handicapé. analyse d'un cas clinique / Study of the maternal and paternal function in the psychical constitution of a child with disability. analysis of a clinical case / Estudo da função materna e paterna na constituição psíquica de uma criança com deficiência. análise de um caso clínico

A partir del recorte longitudinal del caso clínico de un niño, se analiza el despliegue de la función materna y paterna en el devenir de su constitución psíquica, las implicancias en su desarrollo y cómo va evolucionando a partir de un cambio en el posicionamiento de ambos padres. Las manifestaciones del juego del niño, la expresión de su lenguaje, y la organización del yo desde un enfoque metapsicológico, son las fuentes para analizar el desarrollo psíquico. A su vez, se contempla el impacto de la llegada del diagnóstico de TEA, enlazado al de discapacidad, y las implicancias aparejadas AU

À partir de la coupe longitudinale d'un cas clinique d'un enfant, le déploiement de la fonction maternelle et paternelle dans le développement de leur constitution psychique est analysé, les implications sur son développement et comment il évolue à partir d'un changement de positionnement des deux parents. Les manifestations du jeu de l'enfant, l'expression de leur langage, et l'organisation de soi à partir d'une approche métapsychologique, sont les sources pour analyser le développement psychique. Parallèlement, l'impact de l'arrivée du diagnostic de autisme est envisagé, liés au invalidité, et aux implications qui y sont associées AU

From the longitudinal section of the clinical case of a child, the deployment of the maternal and paternal function in the development of their psychic constitution is analyzed, including the implications for its development and how it evolves from a change in the positioning of both parents. The manifestations of the child's play, the expression of his language, and the organization of the self from a metapsychological approach, are the sources to analyze psychic development. At the same time, the impact of the arrival of the diagnosis of autism, linked to that of disability, and the associated implications are considered AU

Resumo Do corte longitudinal de um caso clínico de uma criança, analisa-se o desdobramento da função materna e paterna no desenvolvimento de sua constituição psíquica, as implicações para o seu desenvolvimento e como ele evolui a partir de uma mudança no posicionamento de ambos os pais. As manifestações da brincadeira infantil, a expressão da sua língua, e a organização do eu a partir de uma abordagem metapsicológica, eles são as fontes para analisar o desenvolvimento psíquico. Ao mesmo tempo, contempla-se o impacto da chegada do diagnóstico de autismo, ligada à deficiência, e as implicações decorrentes AU

[The benefits of a psychologist working alongside caregivers in neonatal and pediatric intensive care units]. / De l'intérêt d'un psychologue aux côtés des soignants en réanimation néonatale et pédiatrique.

Neonatal and pediatric intensive care units take care of patients in very critical condition. Professionals in these departments are faced with extreme clinical conditions and a heavy burden of care. The heavy burden of care and the constant confrontation with illness and death have prompted some departments to create psychologist posts dedicated to the nursing staff. By providing a space for thought and reflection, these psychologists act as psychic containers and emotional receptacles for the teams. By working on the otherness of caregivers, the psychologist takes care of those who care.

Functional and radiographic analysis of a cohort of 48 Tactys® prostheses with an average follow-up of 5 years: A retrospective study.

OBJECTIVES: The Tactys® prosthesis is an anatomical unconstrained sliding implant with 4 modular components, designed for proximal interphalangeal arthroplasty. The main objective of our study was to evaluate medium-term functional outcomes at a minimum follow-up of 1 year. MATERIALS AND METHODS: Forty-eight implants were studied, with a mean follow-up of 4.8 years. The study retrospectively analyzed functional, clinical and radiological results. Complications and re-interventions were also analyzed. RESULTS: Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Patient-Rated Wrist Evaluation (PRWE) scores improved from 40.9 to 17.7 and from 47. 1 to 11 .2, respectively (p < 0.001) at last follow-up. Seventy-seven percent of patients rated their results as good or very good, and 83% were willing to undergo the procedure again. Pain on VAS improved significantly from 7.9 to 0.8/10 (p < 0.001). There was no significant difference in range of motion (53° vs 48°), grip strength (14.9 kgF vs 14.6 kgF), or pinch strength (3.4 kgF vs 3.4 kgF). There were no cases of fracture or loosening of implants. Periarticular ossification without functional impairment was observed in 31 patients. Axial deviation was generally corrected. Three surgical re-interventions were required, including 2 implant revisions using a silicone spacer. Five-year implant survival was 94%. CONCLUSION: The Tactys® prosthesis was a reliable and effective option for the management of proximal interphalangeal osteoarthritis. Patient satisfaction was generally good, with improvement in pain and function; however, longer-term follow-up is needed.

[Assessment and impairment of cognitive functions]. / Évaluation et atteintes des fonctions cognitives.

Cognitive functions enable us to receive, select, store, transform, process and retrieve the information we receive from the outside world. These functions are controlled by different brain structures that interact with each other, enabling us to interact with and understand the world around us. In the course of aging or the onset of neurocognitive diseases, these functions may be impaired to a greater or lesser extent, giving rise to a considerable variety of neurocognitive impairment profiles. When a patient appears to be suffering from neurocognitive disorders, a thorough neuropsychological evaluation can help to characterize this impairment precisely, before guiding therapeutic management. It also contributes significantly to the etiological diagnosis of the disorder.

Sonhos possíveis e a relação transferencial / Possible dreams and the transferential relationship / Les rêves possibles et la relation transférentielle

Ogden (2010a) apresenta-nos uma teoria da clínica em que o sonhar é tomado como função de elaboração inconsciente, sendo a incapacidade do sujeito de "sonhar sua experiência emocional" um indicador de sofrimento psíquico. Tendo essa ideia como referência, assim como a teorização de Bion sobre a função alfa e o pensamento-sonho, falaremos no presente trabalho sobre o comprometimento da capacidade de sonhar e seus ecos para o psiquismo do sujeito. Com a apresentação de um caso clínico traremos ainda uma discussão sobre o mecanismo da identificação projetiva e seu valor de comunicação em análise.

Ogden (2010a) presents us with a theory of the clinic in which dreaming is taken as a function of unconscious elaboration, being the subject's inability to "dream his emotional experience" an indicator of psychological suffering. Taking this idea as a reference, as well as Bion's theorization about the alpha function and dream thoughts, in this work we will approach the compromise of the ability to dream and its echoes to the subject's psyche. We will present a clinical case and we will also discuss the mechanism of projective identification and its value of communication in analytical treatment.

Ogden (2010a) nous présente une théorie de la clinique dans laquelle le rêve est pris en fonction de l'élaboration inconsciente, et l'incapacité du sujet à «rêver son expérience émotionnelle¼ étant un indicateur de la souffrance psychique. Prenant cette idée comme référence, ainsi que la théorisation de Bion sur la fonction alpha et la pensée du rêve, nous parlerons dans le présent travail de l'incapacité de rêver et de ses échos à la psyché du sujet. Avec la présentation d'un cas clinique, nous aborderons également le mécanisme d'identification projective et sa valeur de communication en cours d'analyse.

[Anchor your resources with the bullet journal]. / "Encrer" ses ressources avec le bullet journal.

The ordeal of chronicity is marked, from the outside, by an impression of dependence on the institution. Considering the discharge of a patient who has been hospitalized for a long period of time requires reflection at different levels and is based on a major challenge, that of integrating a new model of care. The clinical situation presented allows us to highlight both the caregiving skills and the impact on the group that this implies in a clearly defined dynamic: mobilizing the patient's resources.