Autisme et médiation thérapeutique avec le cheval monté à cru. Amplification de la qualité paternelle du holding et éclosion d’un moi-corporel

This clinic research focuses on subjects with autistic disorders, which perform equitation therapy sessions. Early work has shown the interest of the horse as a therapeutic mediation for situation with autism. Indeed, the horse favors in a suitable relational framework sensory experiences that are likely to support the construction of body's image and symbolizing effects. Our hypothesis relates specifically to the contact of the rider with the animal. The raw lift (without saddle) would sustain, through its behavioral and psychic potentialities, a gathering of the image of the body. The subject followed is 17 years old and is called Yohan. The weekly equine therapy sessions were held over six months. The clinical material results from careful observations, which were subsequently analyzed. A longitudinal assessment is performed with the Psychodynamic Assessment Scale of Changes in Autism (EPCA, Haag et al.). The analysis of the therapeutic process is then discussed with that of two other autistic subjects who benefited from this same therapeutic mediation. This study shows the value of mediation with the horse and especially the interest of the riding without saddle. The experiences gained would in this context have repercussions on the gathering of their body image, their psychic envelopes and on their internal security.     

Estimating net survival: the importance of allowing for informative censoring

Net survival, the one that would be observed if cancer were the only cause of death, is the most appropriate indicator to compare cancer mortality between areas or countries. Several parametric and non-parametric methods have been developed to estimate net survival, particularly when the cause of death is unknown. These methods are based either on the relative survival ratio or on the additive excess hazard model, the latter using the general population mortality hazard to estimate the excess mortality hazard (the hazard related to net survival). The present work used simulations to compare estimator abilities to estimate net survival in different settings such as the presence/absence of an age effect on the excess mortality hazard or on the potential time of follow-up, knowing that this covariate has an effect on the general population mortality hazard too. It showed that when age affected the excess mortality hazard, most estimators, including specific survival, were biased. Only two estimators were appropriate to estimate net survival. The first is based on a multivariable excess hazard model that includes age as covariate. The second is non-parametric and is based on the inverse probability weighting. These estimators take differently into account the informative censoring induced by the expected mortality process. The former offers great flexibility whereas the latter requires neither the assumption of a specific distribution nor a model-building strategy. Because of its simplicity and availability in commonly used software, the nonparametric estimator should be considered by cancer registries for population-based studies.     

Pseudohypoaldosteronisms, report on a 10-patient series

Background. Type 1 pseudohypoaldosteronism (PHA1) is a salt-wastingsyndrome caused by mineralocorticoid resistance. Autosomal recessiveand dominant hereditary forms are caused by Epithelial Na Channeland Mineralocorticoid Receptor mutation respectively, whilesecondary PHA1 is usually associated with urological problems. Methods. Ten patients were studied in four French pediatricunits in order to characterize PHA1 spectrum in infants. Patientswere selected by chart review. Genetic, clinical and biochemistrydata were collected and analyzed. Results. Autosomal recessive PHA1 (n = 3) was diagnosed at 6and 7 days of life in three patients presenting with severehyperkalaemia and weight loss. After 8 months, 3 and 5 yearson follow-up, neurological development and longitudinal growthwas normal with high sodium supplementation. Autosomal dominant PHA1 (n = 4) was revealed at 15, 19, 22 and30 days of life because of failure to thrive. At 8 months, 3and 21 years of age, longitudinal growth was normal in threepatients who were given salt supplementation; no significantcatch-up growth was obtained in the last patient at 20 monthsof age. Secondary PHA1 (n = 3) was diagnosed at 11, 26 days and 5 monthsof life concomitantly with acute pyelonephritis in three childrenwith either renal hypoplasia, urinary duplication or bilateralmegaureter. The outcome was favourable and salt supplementationwas discontinued after 3, 11 and 13 months. Conclusions. PHA1 should be suspected in case of severe hyperkalemiaand weight loss in infants and need careful management. Pathogenesisof secondary PHA1 is still challenging and further studies aremandatory to highlight the link between infection, developingurinary tract and pseudohypoaldosteronism.     

Molecular characterization of cell substratum attachments in human glial tumors relates to prognostic features

Glioma cell attachments to substratum play crucial roles in the invasion by glioma cells of normal brain tissue. These attachments are mediated through interactions between extracellular matrix (ECM) components, integrins, focal adhesion‐linked molecules, and the actin cytoskeleton. In the present study, we investigate the molecular elements involved in cell substratum attachments in human glial tumors and their potential relationships to prognostic features. We used 10 human glioma cell lines, for which we characterized glial differentiation by means of quantitative RT‐PCR for nestin, vimentin, and GFAP mRNA. We quantitatively determined the amounts of laminin, fibronectin, vitronectin, and thrombospondin secreted by these glioma cell lines in vitro, as well as the amount of each of the eight β integrin subunits and the adhesion complex‐related molecules, including talin, vinculin, profilin, zyxin, α‐actinin, paxillin, and VASP. After quantification of the levels of migration and invasion of these 10 cell lines in vitro and, through grafts into the brains of nude mice, of their biological aggressiveness in vivo, it appeared that the levels of the β5 integrin subunit and α‐actinin were directly related to biological aggressiveness. These experimental data were clinically confirmed because increasing immunohistochemical amounts of the β5 integrin subunit and α‐actinin were directly related to dismal prognoses in the case of astrocytic tumors. In addition, we show that the β4 integrin subunit are expressed significantly more in oligodendrogliomas than in astrocytic tumors. A potential role for the β8 integrin subunit in glioma cell substratum attachments is also emphasized. GLIA 36:375–390, 2001. © 2001 Wiley‐Liss, Inc.     

Merits and limitations of continuous blood volume monitoring during haemodialysis: Summary of the EDTNA|ERCA Journal Club discussion: winter 2005

The discussion explored and expanded on the issues raised by Dasselaar et al in their review of the measurement of relative blood volume (RBV) changes during dialysis (NDT 2005). Dialysis machines incorporating blood volume monitoring and control are widely available in Europe. The use of continuous blood volume monitoring (CBVM) to help establish dry weight; problems with CBVM due to connection and use of single needle dialysis; the physiological processes that cause RBV changes during eating, exercise and posture changes; and the application of blood volume based biofeedback control were discussed by participants from ten countries. The ‘take‐home’ messages from the discussion were that CBVM can assist in setting target weight, but must be used together with traditional measures and experience. Biofeedback control may help to achieve symptom‐free dialysis, but staff should be prepared to monitor patients systematically for several weeks to obtain individualised settings. Users of CBVM should be aware of factors that can alter the central haematocrit leading to apparent changes in RBV. Practical guidelines should be developed to help staff interpret CBVM data effectively.     

DNASE1L3 deficiency,new phenotypes,and evidence for a transient type I IFN signaling

Journal of Clinical Immunology - Deoxyribonuclease 1 like 3 (DNASE1L3) is a secreted enzyme that has been shown to digest the extracellular chromatin derived from apoptotic bodies, and DNASE1L3...     

End-systolic left ventricular pressure-dimension shift during acute relief of volume overload in the conscious dog

To test whether left ventricular (LV) end-systolic dimensions are determined only by end-systolic pressure for a given inotropic state, 7 conscious dogs were studied during abrupt closure of a fistula created between the left subclavian artery and the left atrial appendage. The dogs were instrumented with an LV pressure micromanometer and ultrasonic crystals measuring LV major- and minor-axis diameters and ventricular wall thickness. During beta-blockade treatment and for the same end-systolic pressure, closure of the fistula produced a 40% decrease in cardiac output; end-diastolic diameter decreased by 1.5 mm and end-systolic diameter decreased by 0.9 mm. Calculated end-systolic volume was similarly decreased by 1.3 ml for a decrease of 2.9 ml of end-diastolic volume. Thus, large end-diastolic dimensional variations associated with peripheral resistance decrease significantly modify the end-systolic pressure-diameter (and volume) relations in the conscious animal. It is suggested that indexes obtained from these relations should not be used in patients when systolic pressure variations are associated with large stroke volume variations.     

Trends in survival after cancer diagnosis among HIV‐infected individuals between 1992 and 2009. Results from the FHDH‐ANRS CO4 cohort

Although the decline in cancer mortality rates with the advent of combination antiretroviral therapy (cART) in HIV‐infected individuals can be mostly explained by a decrease in cancers incidence, we looked here if improved survival after cancer diagnosis could also contribute to this decline. Survival trends were analyzed for most frequent cancers in the HIV‐infected population followed in the French Hospital Database on HIV: 979 and 2,760 cases of visceral and non‐visceral Kaposi's sarcoma (KS), 2,339 and 461 cases of non‐Hodgkin lymphoma (NHL) and Hodgkin's lymphoma (HL), 446 lung, 312 liver and 257 anal cancers. Five‐year Kaplan–Meier survival rates were estimated for four periods: 1992–1996, 1997–2000, 2001–2004 and 2005–2009. Cox proportional hazard models were used to compare survival across the periods, after adjustment for confounding factors. For 2001–2004, survival was compared to the general population after standardization on age and sex. Between the pre‐cART (1992–1996) and early‐cART (1997–2000) periods, survival improved after KS, NHL, HL and anal cancer and remained stable after lung and liver cancers. During the cART era, 5‐year survival improved after visceral and non‐visceral KS, NHL, HL and liver cancer, being 83, 92, 65, 87 and 19% in 2005–2009, respectively, and remained stable after lung and anal cancers, being 16 and 65%, respectively. Compared with the general population, survival in HIV‐infected individuals in 2001–2004 was poorer for hematological malignancies and similar for solid tumors. For hematological malignancies, survival continues to improve after 2004, suggesting that the gap between the HIV‐infected and general populations will close in the future.