Encéphalite à tiques en Europe de l'Est

Tick-borne encephalitis (TBE) is a flavivirus infection endemic in a large area ranging from the East of Russia to Central and Eastern Europe and Scandinavia. TBE is transmitted to humans by the bite of Ixodes tick, or following the consumption of infected unpasteurized cow or goat milk. The clinical symptoms of TBE are caused by a biphasic viremia: a nonspecific febrile illness and then central nervous system damage. This biphasic course of the disease is observed in close to 70% of TBE cases in Europe. Analysis of the cerebrospinal fluid shows a mononuclear pleocytosis along with a normal or moderately elevated protein level as well as a normal glucose level. The specific diagnosis is based on the detection of IgM antibodies to TBE virus in serum. Treatment of TBE patients is targeted at symptoms, since no specific treatment for TBE is available. The mortality rate of TBE in Europe is 0–3.9%. The post TBE recovery lasts about one year and sequelae occur in about 1/3 of the cases. Active vaccination appears to be the most effective means of preventing TBE. 2 vaccines against TBE are licensed in Europe: FSME-Immun^TM Inject, Immuno AG, Austria and Encepur^®, Chiron-Behring, Germany. The vaccines appear to protect against both Eastern and Western virus subtypes.     

Introduction à la psychothérapie analytique de groupe

International Journal of Public Health - Faisant suite à une brève énumération des différentes techniques de psychothérapie collective, méthodes purement...     

Conduite à tenir devant des troubles de la déglutition

Swallowing disorders are frequent in daily practice. They could involve liquids or solid diets or both, and are mainly caused by neurological or ENT diseases. They impair patients or their relatives’ quality of life and increase the risks of aspiration, undernutrition and dehydration. Assessment includes careful interview and physical examination. The DePippo's test is a key examination. Additionally, endoscopy or video fluoroscopy, which remains the gold standard for swallowing assessment, could be needed. Nutritional and respiratory assessments are mandatory. The management of swallowing disorders should be multidisciplinary, involving physicians, speech therapist, dietician, sometimes dentist or surgeon, and needs a strong contribution of the paramedical staff and the patient's relatives.