Trajectories of perceived economic hardship: Relations with mother's and child's mental health and the role of self-esteem.

Trajectories of poverty influence the mental health of mothers and children. Previous studies utilize objective measures despite the importance of subjective measures of poverty. Furthermore, chronic economic hardship may erode personal resources such as self-esteem which increases vulnerability to mental health issues. Trajectories of perceived family economic hardship and their relationship with common mental health disorders, as mediated by self-esteem, were investigated in 511 mother-child dyads from Singapore. Three distinct groups of economic hardship trajectories were delineated, namely the low stable, high stable and moderate decreasing group. The high stable group was found to be associated with a greater likelihood of mother's depression, mother's anxiety and child's anxiety when compared to the low stable group. The moderate decreasing group was found to be associated with a greater likelihood of mother's anxiety when compared to the low stable group. Mother's self-esteem was found to mediate all the significant relations found. These findings indicate the existence of distinct trajectories of perceived economic hardship within low-income families and their relation with mental health outcomes in mothers and children. The mediation of these relations by mother's self-esteem suggests the importance of enhancing self-esteem in mothers from low-income backgrounds.

[Correlation between ICIQ-UI-SF score and personality testing results over a urinary incontinent population]. / Corrélation entre le score de l'ICIQ-UI-SF et les résultats d'un test psychométrique de personnalité d'une population ayant une incontinence urinaire.

OBJECTIVE: We found out the personality pattern of an incontinent population and proceeded to a correlation between the personality inventory and the ICIQ-UI-SF (International Consultation Incontinence Questionnaire Urinary Incontinence Short Form) to demonstrate reliability and sincerity of the answers and to establish that a personality disturbance may impact the physiopathology of micturition. MATERIALS AND METHODS: We performed an observational prospective study. It included patient's answers to a computed questionnaire combining a double ICIQ-UI-SF questionnaire and the 71 questions of the Minimult questionnaire. Forty-seven patients were asked to participate. RESULTS: Over 37 patients included, Wilcoxon-Mann-Whitney non parametric test confirmed agreement of the two ICIQ-UI-SF questionnaires with P=0.1792. Twenty-three patients were validated to the Minimult inventory with F scale<70. We analysed variability of the two global ICIQ-UI-SF score in regard with the validity scale using ROC analysis. We observed an AUC of 0.559 with sensitivity 78.6% and specificity 43.5%. No L score was above 70 demonstrating absence of lie. No personality disturbance was found in 9 cases. We observed six cases with a high hypochondric value, five with a high depressive value, and four with a high hysteric value. This neurotic triad was found in two cases. We noticed five cases with psychopathic deviance relative to antisocial behaviour while values of paranoia and hypomania were high in one case without any association of these personality aspects, which demonstrated absence of behavioural problem. Psychotic profile associating schizophrenia, paranoia, depression and hypomania was not found. We outlined in half of the valid population a significant high psycho-asthenic pattern. CONCLUSION: We conclude that a correlation between the personality inventory and the ICIQ-UI-SF is feasible. The comparative study demonstrate reliability of answers. Sincerity is established by the Minimult L scale. We confirm and precise literature information over clinical personality pattern of this population and observe relevant elements concerning the psycho-asthenic pattern which depicts an anxious personality with an important feeling of the problem. These elements permit to suspect that a personality disturbance may impact the physiopathology of the micturition. LEVEL OF EVIDENCE: 4.

IFNγ-Stimulated B Cells Inhibit T Follicular Helper Cells and Protect Against Atherosclerosis.

B and T cells are interconnected in the T follicular helper-germinal center B cell (TFH-GC B cell) axis, which is hyperactive during atherosclerosis development and loss of control along this axis results in exacerbated atherosclerosis. Inhibition of the TFH-GC B cell axis can be achieved by providing negative co-stimulation to TFH cells through the PD-1/PD-L1 pathway. Therefore, we investigated a novel therapeutic strategy using PD-L1-expressing B cells to inhibit atherosclerosis. We found that IFNγ-stimulated B cells significantly enhanced PD-L1 expression and limited TFH cell development. To determine whether IFNγ-B cells can reduce collar-induced atherosclerosis, apoE -/- mice fed a Western-type diet were treated with PBS, B cells or IFNγ-B cells for a total of 5 weeks following collar placement. IFNγ-B cells significantly increased PD-L1hi GC B cells and reduced plasmablasts. Interestingly, IFNγ-B cells-treated mice show increased atheroprotective Tregs and T cell-derived IL-10. In line with these findings, we observed a significant reduction in total lesion volume in carotid arteries of IFNγ-B cells-treated mice compared to PBS-treated mice and a similar trend was observed compared to B cell-treated mice. In conclusion, our data show that IFNγ-stimulated B cells strongly upregulate PD-L1, inhibit TFH cell responses and protect against atherosclerosis.

Supervisory attentional system in nonamnesic alcoholic men.

BACKGROUND: Many studies have shown that recently detoxified alcoholic persons perform poorly on tasks thought to be sensitive to frontal lobe damage, supporting the hypothesis that the frontal lobes are highly vulnerable to chronic alcohol consumption. However, it appeared that most of the executive tasks used in these studies also involved nonexecutive components, and these tasks had been shown to be impaired as a result of nonfrontal lobe lesions. In this study, we examined further the "frontal lobe vulnerability" hypothesis using executive tasks, proved to be associated with frontal lobe functioning, that allowed us to distinguish the relative importance of executive and nonexecutive processes. METHOD: Thirty recently detoxified asymptomatic male alcoholic inpatients and 30 control subjects were tested for planning, inhibition, rule detection, and coordination of dual task, as well as the speed of processing and nonexecutive functions (such as short-term memory storage). RESULTS: Alcoholics performed worse than controls in almost all tasks assessing executive functions. However, they were not slower than the controls and showed normal results for nonexecutive functions. CONCLUSIONS: Chronic alcohol consumption seems to be associated with severe executive function deficits, which are still present after a protracted period of alcohol abstinence. These data support the idea that the cognitive deficits in recently detoxified sober alcoholic subjects are due, at least partly, to frontal lobe dysfunctioning.

Clonidine-induced growth hormone secretion in elderly patients with senile dementia of the Alzheimer type and major depressive disorder.

This study was undertaken to assess the value of growth hormone (GH) response to clonidine as a tool in the differential diagnosis between depression and dementia. This response is known to be blunted in depression, and neurochemical changes observed in senile dementia of the Alzheimer type (SDAT) could lead to an up-regulation of GH secretion. No difference was observed between GH response in depressed and demented patients. Together with studies on GH basal secretion in Alzheimer's disease, this finding suggests that the final consequence of SDAT-related changes in an accentuation of the effects of aging on GH reactivity.

[Psychic disturbance in normal pressure hydrocephalus (author's transl)]. / Troubles psychiques au cours d'hydrocéphalie normotensive.

After reviewing the literature on psychic disturbance in normal pressure hydrocephalus, the author reports on 26 cases of CSF drainage. Impairment of memory and concentration were always present in normal pressure hydrocephalus; behaviour disorders were very frequent and characterized by both types of frontal behaviour; the mental picture also comprised difficulties of calculation, writing, visuoconstructive praxis and, less frequently, impaired speech and reading ability. CSF drainage brought clinical improvement in 73% of the cases. Disorders of consciousness, mental function and behaviour regressed generally progressively as soon as the operation had been performed. Two major factors affecting therapeutic efficacity appear to be the patient's age and the length of time between onset of the symptoms and start of therapy.

[Prognostic factors for therapeutic outcome in normal-pressure hydrocephalus. Review of the literature and personal study]. / Facteurs pronostiques du résultat thérapeutique dans l'hydrocéphalie à pression normale. Revue de la littérature et étude personnelle.

In view of the unpredictable percentage of NPH patients who benefit from surgery and the risk of postoperative complications, the study of predictive parameters appears essential. The literature shows many conflicting results in studies which focus on predictive values. The present study is based on a series of 63 patients, all of whom underwent surgery for NPH. Fifty one historical, clinical, paraclinical and neuropsychological parameters were submitted to statistical analysis on the basis of the postoperative results. Nine of these parameters were correlated with the postoperative evolution: aetiology, chronic alcoholism and seven neuropsychological signs, in particular verbal signs. A statistical analysis by logistical regression allows us to describe an optimum predictive model. The most significant results are discussed.

[Epileptic psychosis--ictal psychosis?]. / Psychose épileptique--psychose ictale?

A 54-year-old female patient presented acute hallucinatory psychotic episodes with irritative EEG for seven years before an initial state of complex partial mal. A single convulsive episode occurred 14 years after the beginning of the psychiatric symptoms. The intercritical EEG showed independent temporal lobe foci predominating on the right. It varied little during delirious phases but these occurred three times during weaning from antiepileptic drugs. The delirium improved when the treatment was restored, whereas neuroleptics proved ineffective. Psychiatric signs frequently described in epilepsy and particularly temporal epilepsy are reviewed. Usually, these symptoms are not concomitant. The literature mentions only a very few cases where psychosis appears to be ictal as in the reported case.

[Post-traumatic mutism. A report of five cases (author's transl)]. / Le mutisme post-traumatique. A propos de cinq cas.

After a review of current concepts about post-traumatic mutism, the authors describe five patients with this unusual symptom. The study extends on a long follow-up period. Differential diagnosis and possible neurological and psychopathological factors are discussed. Analysis of their personal observations leads the authors to think that there is a relationship between the length of coma and the duration of mutism. Frontal and/or bilateral lesions seem to be more likely to produce post-traumatic mutism, as does the existence of emotional disturbances or depressive symptoms in past history.

[Hydrocephalic and/or degenerative dementia]. / Démence hydrocéphalique et/ou dégénérative.

The authors report ten cases of progressive dementia. Nine are associated with gait disturbances and seven with urinary incontinence. Despite the severity of dementia and Ct Scan signs of cortical atrophy, magnitude of neuroradiological ventricular dilatation and ventricular reflux at isotopic cisternography lead to shunt therapy. After ventricular shunting of CSF, a follow-up at short and long terms shows different clinical evolutions: two transitory improvements, three cases without change and five worsening. Retrospective clinical study of these cases in which diagnosis leads to a degenerative process of the Alzheimer type shows atypical premorbid neuropsychological characteristics by a normal-pressure hydrocephalus. In fact, in the ten cases preoperative neuropsychological investigation shows, at various levels, aphasic, alexic and agraphic signs. Their occurrence in the clinical picture represents an essential contribution to differential diagnosis.

[Loss of mental images]. / La perte des images souvenirs.

The authors report a case of loss of mental imagery in a 35 year old male patient who was operated on for an intraventricular meningioma in the region of the left trigonum collaterale. The symptomatology and its evolution are described. Discussion of the pathophysiologic hypotheses is focused on the possible role of a selective memory disturbance, of a functional disconnection between language- and visual representation-areas of the brain, and of visual agnosia. In the reported case, the underlying pathophysiologic mechanism seems to be very close to the one responsible for visual agnosia, and could be explained as a partial dissolution of visual memories. Analysis of 35 cases of loss of mental imagery reported in the literature shows that the investigation of this peculiar disturbance is in many cases incomplete. It nevertheless reveals that visual agnosia, or a particular form of visual agnosia, is present in all cases of unilateral posterior lesion of the dominant hemisphere.

[Pseudo-Hakim-Adams syndrome. Neuropsychological study of 23 cases of misdiagnosed Hakim-Adams syndrome]. / Pseudo-syndrome de Hakim et Adams. Etude neuropsychologique de 23 cas de faux diagnostic de syndrome de Hakim et Adams.

The authors study the characteristics of a group of 23 patients for whom an initial tentative diagnosis of Hakim-Adams syndrome (H-A syndrome) was eventually rejected. On account of several factors distinguishing these patients from the true H-A group, the authors propose using the term "pseudo Hakim-Adams syndrome". The distinguishing factors include: the grounds for admission, i.e. mental or mnesic deterioration, associated with radiological images of ventricular dilatation; a clinical picture dominated by mental disorders with only rare disorders of gait and sphincter control (several neurological defects were direct consequences of previous cerebral disease); no antecedents of spontaneous meningeal hemorrhage or meningitis in the case history; neuropsychological examination showing fewer disorders of concentration and less dyscalculia and constructive dyspraxia than in true HA, and far more atypical signs of the aphasic and anxio-depressive type. The authors think that various pathological processes may be responsible for this pseudo H-A syndrome in which a predominant mental picture is associated with ventricular dilatation.

Effects of methionine hydroxy analog on voluntary intake, digestibility, nitrogen balance, and chewing behavior in sheep fed grass silage.

Voluntary intake, digestibility, N balance, and chewing behavior of six 6-mo-old (young) and six 30-mo-old (mature) Texel wethers (32.6 and 83.1 kg average BW) given ad libitum access to grass silage and 100 g of top-dressed soybean meal with or without 5 g of methionine hydroxy analog (MHA) in the acid form were examined according to a two-period crossover design. Supplementation level of MHA in the acid form corresponded to .32 and .16 g of MHA/kg BW.75, respectively, in young and mature wethers. There was no effect (P greater than .10) of MHA on mean voluntary DMI. Methionine hydroxy analog supplementation increased (P less than .02) digestibility of DM, OM, and CP by young wethers but not (P greater than .18) by mature wethers. The MHA decreased eating time (P less than .03) in both young and mature wethers and intake level (P = .01) in young wethers during the first 1.5 h of access to grass silage. With MHA, both age groups increased (P less than .05) the daily number of meals and decreased (P less than .02) the mean duration of each meal. There was no effect (P greater than .06) of MHA on daily and unitary eating, ruminating, and masticating times; however, mean duration of consecutive rumination bolus cycles was longer (7.2%; P = .01) in young wethers. Young vs mature sheep ate more (53.4 vs 39.3 g of DM/[d.kg BW.75]; P less than .001) and had shorter unitary mastication times (P = .001). Results suggest that, depending on its relative level of supplementation, MHA in the acid form could act through both palatability and effects on ruminal metabolism.

[Revascularization of the extracranial carotid-, vertebral- and subclavian arteries in a small peripheral hospital (author's transl)]. / Extra-craniële arteria carotis-, vertebralis- en subclavia revascularizatie in een perifeer ziekenhuis.

A total of 21 procedures were performed on a group of 17 patients, 13 of them more than 65 years old, for mixed intra- and extracranial vessel disease. Ten had recovered from a frank stroke. Thirteen of them underwent one procedure, three two procedures and one a total of three revascularizations. Eighteen carotid endarterectomies, without patch angioplasty were performed. The determinant factor whether or not to use an intraluminal shunt was the peroperatory encephalographic monitoring by a neurologist. The shunt was used any time significant EEG changes occurred during a test clamping period of five minutes. The other procedures included a vertebral artery endarterectomy with patch angioplasty, a subclavian- subclavian vein by-pass, as well as a common carotid artery resection for elongation and kinking of the internal carotid artery combined with marked stenosis. The mortality was nihil. Postoperatively all patients did well with an improved mental and neurological status.

[Computer hardware for a surgical service]. / Over de hardware bij computing in een heelkundige dienst.

While the bulk of all medical information is text, we think that the hardware needed to collect this information and to store it in a databank, must be essentially a first class work processor, working in a multi-user system with terminals where this information is gathered: the nursing stations, operating theatres, outpatient clinics and a working and archiving station centrally placed and capable to link those different terminals and those from other services as well.

[Indications, method and results of autotransfusion in trauma and vascular surgery (author's transl)]. / Indikaties, methodiek en uitslagen van de autotransfusie in vasculaire en traumachirurgie

The authors have used the Bentley Ats 100 system, a disposable autotransfusion unit, in 31 cases of trauma and major vascular surgery. An original method of anticoagulation consisting in heparine (1 mg/kg bodyweight) and priming and flushing of the succion unit with ACD is described. The effect of the autotransfusion on the coagulation and the recent problems and advances are discussed.

Pilonidal sinus. Excision--marsupialization--phenolization?

Too often still this disease is called sacrococcygeal cyst, pointing into the direction of congenital etiology. With this paper (and a review of the literature) we try to proof that the theory of acquired origin of pilonidal sinus is the only one logically to be accepted. We indicate that extensive surgical procedures such as Z-plasty rotated flap or broad excision--are really unnecessary and that a simple and accurate technique--marsupialization--gives excellent results with a minimum of recurrences. The last few years phenolization of the pilonidal sinus has become a popular, and eventually a worthwhile alternative.

Treatment of alkaline reflux gastritis. A report of twenty cases.

The surgical treatment of twenty patients operated for postoperative alkaline reflux gastritis is discussed together with the pathogenesis of this syndrome as a late postoperative surgery syndrome. Diagnostic procedures and results of investigations and treatment were compared with data of the literature. Surgical treatment is of great benefit. The different surgical technics should be used according their own indication.

[Post-traumatic dementia]. / Les démences post-traumatiques.

On the basis of a retrospective study concerning 63 cases of normal pressure hydrocephalus, the author examines the characteristics of patients with a traumatic aetiology who were not ameliorated by a ventricular derivation. Four of these patients suffering from a post-traumatic dementia are described. Reviewing the literature, several topics concerning post-traumatic dementia are considered: incidence, time delay before diagnosis, variation of pictures, aetiopathogenic explanations, medico-legal problems encountered with Alzheimer's of Pick's diseases. Finally the differential diagnostic characteristics between the curable and incurable forms of post-traumatic dementia syndromes are discussed.

[Post traumatic schizophrenic bouts: with regard to 6 cases of traumatic schizophrenia (author's transl)]. / Les décompensations schizophréniques post-traumatiques. A propos de 6 cas de schizophrénie traumatique.

The authors describe 6 cases of post-traumatic schizophrenia and make a critical review of the literature concerning this unusual post-traumatic personality disturbance. Various schizophrenic manifestations are observed: they principally consist of delusion, hallucination, paranoid and mystical ideas, autism, psychomotor instability, fugues. Post-traumatic schizophrenia occurs mostly in young men, before thirty years. The severity of traumatic brain injury appears irrelevant in its genesis. Temporal lobes are more often involved (one third of the cases). Pre-traumatic personality disturbances are the main factor as demonstrated by the anamnesis and by the results of Rorschach test.