Short-term retention effect of rehabilitation using head position-based electrotactile feedback to the tongue: Influence of vestibular loss and old-age

Our objective was to evaluate whether the severity of vestibular loss and old-age (>65) affect a patient's ability to benefit from training using head-position based, tongue-placed electrotactile feedback. Seventy-one chronic dizzy patients, who had reached a plateau with their conventional rehabilitation, followed six 1-h training sessions during 4 consecutive days (once on days 1 and 4, twice on days 2 and 3). They presented bilateral vestibular areflexia (BVA), bilateral vestibular losses (BVL), unilateral vestibular areflexia or unilateral vestibular losses and were divided into two age-subgroups (≤65 and >65). Posturographic assessments were performed without the device, 4 h before and after the training. Patients were tested with eyes opened and eyes closed (EC) on static and dynamic (passively tilting) platforms. The studied posturographic scores improved significantly, especially under test conditions restricting either visual or somatosensory input. This 4-h retention effect was greater in older compared to younger patients and was proportional to the degree of vestibular loss, patients with increased vestibular losses showing greater improvements. In bilateral patients, who constantly fell under dynamic-EC condition at the baseline, the therapy effect was expressed by disappearance of falls in BVL and significant prolongation in time-to-fall in BVA subgroups.Globally, our data showed that short training with head-position based, tongue-placed electrotactile biofeedback improves balance in chronic vestibulopathic patients some 16.74% beyond that achieved with standard balance physiotherapy. Further studies with longer use of this biofeedback are needed to investigate whether this approach could have long-lasting retention effect on balance and quality of life.     

Innocence et culpabilité pathologiques

Innocence and culpability are two realities of the experiment human at the same time paradoxical and contrary and capable of subtle intrications. After having approached the roots of these two great concepts in their historical concepts, we will be able to traverse the fields specific to each one of them. Innocence is very early in the history reported to the problems of the young children and their violent death to mean the values of a moral and spiritual nature thereafter. The culpability refers as of the Antiquity to the fault of the culprit and its crime to relate to later the transgressions of a particular group and of its rites. These considerations enable us to seize the specific fields well. Innocence is characterized especially by the style and the manner of living. The experiment of innocence is made vulnerability in direct relationship to the otherness and soustendue of intentionnality. The pathological conviction of innocence is important to include/understand, because it is marked in a context of derealisation darkening the conscience of the acts. And this conviction is in one lived of persecution. The charged act is not recognized and the subject brings it back to the other, in the more or less delirious conviction, always derealized, of its innocence. But, it is advisable to distinguish that well from the refusal. The culpability is an experiment able to invade the personalities. The sociological and psychological designs are with being differentiated well. But, it is important to distinguish well the various methods, culpability real, subjective, morbid, delirious culpability. The latter constitutes the center of pathologies melancholic persons able to take very serious forms many work show us that innocence and the culpability constitute contingent experiments     

Molecular and cellular events of dopamine D1 receptor‐mediated tau phosphorylation in SK‐N‐MC cells

Microtubules are involved in the formation of axons and dendrites, maintenance of neuronal morphology, and cellular trafficking. Recent studies suggest that drugs affecting dopamine activity in the brain can induce cytoskeletal modifications. For instance, we have demonstrated in acute rat brain slices a molecular chain of events connecting dopamine D1 receptor to aberrant phosphorylation of the microtubule‐associated protein tau. However, the molecular and cellular effects of tau phosphorylated by means of the activation of dopamine receptors were unexplored. Here we used SK‐N‐MC cells, which express endogenously functional D1 receptors, to demonstrate that levels of phosphorylated tau at serines 199–202 or 214 are increased by a calcium‐dependent pathway subsequent to D1 receptor stimulation. Using selective pharmacological tools, we showed that enhanced intracellular calcium lead to cyclin‐dependent kinase 5 (cdk5) activation, by calpain proteolysis of p35 to p25, as well as glycogen synthase kinase 3β (GSK3β) activation, by its phosphorylation at tyrosine 216. Interestingly, while the activation of protein kinase A (PKA) led directly to the phosphorylation of tau at serine 214, tau phosphorylation at serines 199–202 was independent of PKA. In addition, inhibition of cdk5 or GSK3β prevented the decrease in cell viability induced by D1 receptor stimulation whereas PKA inhibition had no influence. Our data demonstrate that activation of cdk5 and GSK3β following D1 receptor stimulation could have profound influence on both the neuronal cytoskeletal constituent tau and cell survival in SK‐N‐MC cells. Synapse 65:69–76, 2011. © 2010 Wiley‐Liss, Inc.     

Which medical devices and/or local drug should be curatively used,as of 2012, for PU patients? How can granulation and epidermidalization be promoted? Developing French guidelines for clinical practice

IntroductionManagement of a patient with pressure ulcer sore(s) must associate local and general treatment.ObjectivesTo determine which medical devices other than supports and which treatments may be used for pressure sore healing (granulation tissue and epithelization/epidermidalization) as of 2012.MethodsSystematic review of the literature querying the databases: PASCAL Biomed, PubMed, and Cochrane library from 2000 through 2010.ResultsData in the literature on granulation tissue and epithelisation/epidermidalization in pressure sore healing are poor. The level of evidence regarding the relative effectiveness of one modern dressing compared to another has remained low. However, the study data on the interest of hydrocolloid dressing compared with impregnated gases are more significant.DiscussionStudies with heterogeneous results and populations have shown low power. Meta-analyses are difficult due to the wide range of therapeutic aims. Further clinical studies with adequate methodology are needed prior to elaboration of more specific recommendations.ConclusionThe use of hydrocolloid dressing may be recommended to improve granulation tissue development and epithelization/epidermidalization in pressure sore (Level B).