Structures et ressources pour soutenir la réadaptation des personnes atteintes de schizophrénie

This article is the last one out of a run of three articles on the subject of psychiatric rehabilitation in Quebec. Specifically, it looks at the structures and resources available that support the rehabilitation of people living with schizophrenia. First, the existing structures and resources as well as the recommended values present in Quebec will be described within the context of the current care system. Thereafter, the need for services for people living with schizophrenia will be addressed by situating what could be a balanced and differentiated mental health care system in high revenue countries, such as Canada or France. Finally, the current stakes such as the role of the associative sector, responsibility, evidence based practice and continuing education will be raised.     

Headaches in the First Post Partum Week and Their Relationship to Migraine

SYNOPSIS
15 out of 40 women on a post natal ward had headaches in the first post partum week, particularly between day 3–6 post partum. The incidence of these headaches was increased among women with a previous personal or family history of migraine or pre-menstrual migraine, but they were usually milder and more frequently bilateral than the patients usual migraine. These headaches were not associated with previous neurotic depression or mood changes during the puerperium and are therefore unlikely to be tension headaches. Weight gain preceded the onset of the headache and weight loss followed it, but as these changes occur among women without the headache they are unlikely to be causal, though of interest since similar weight changes sometimes occur with migraine attacks. The rapidly falling levels of estrogen and progesterone, or possibly alterations in serotonin metabolism may be responsible for these headaches, most of which appeared to be mild episodes of common migraine.     

Anomalous Origin of the Left Coronary Artery from the Right Pulmonary Artery Presenting Following Relief of Left Heart Obstruction: A Distinct and Predictable Clinico-Pathological Syndrome

Introduction. Pre-operative recognition of significant abnormalities of the coronary arteries is important in a variety of congenital cardiac conditions. Failure to diagnose anomalous origin of the coronary artery from the pulmonary artery during repair of other anomalies is important because reduction in pulmonary artery pressure will reduce myocardial perfusion pressure. Patients. We report two cases of the rare association of anomalous origin of the left coronary artery from the right pulmonary artery, aortic coarctation, and mitral stenosis. Conclusions. Definitive imaging of coronary artery anatomy by echocardiography or other modalities should form a routine part of diagnostic assessment in all congenital heart disease patients but particularly those with left heart obstruction.