[Contributions of discussion groups in the therapeutic education of bulimic disorders]. / Apports des groupes de parole dans l'éducation thérapeutique des troubles boulimiques.

The treatment of patients suffering from bulimic disorders requires a multidisciplinary approach combining a somatic approach and a psychiatric approach. The Maison des adolescents of the Cochin Hospital offers a therapeutic education program focused on the management of compulsive binge eating. Its modalities have been modified over the years in order to better adjust to the needs of these patients. Monthly discussion groups have been added to the individual interviews, and have been key points in structuring the treatment.

[The discussion group "Maternity wards and cultures, exchanges around cradles"]. / Le groupe de parole "Maternités et cultures, échanges autour des berceaux".

At the Port-Royal maternity ward in Paris (14th arrondissement), a system has been set up as part of the liaison work. The discussion group "Maternities and cultures, exchanges around cradles" offers a sharing and carrying place in this so singular period of "becoming a mother" . Cultural and professional mixing is at the heart of this system. Presentation of observations of the group's movements over two years.

[From the psychiatric sector to the mental health territory]. / Du secteur de psychiatrie au territoire de santé mentale.

There is currently a noticeable change in public health policy, as well as a paradigm shift with the policy of a mental health territory. From a humanist sector policy, centred on the patient, we are moving towards a policy of a mental health territory, which, although taking into account the changing needs of a group of people, no longer considers the specific needs of the individual. The notion of a geographic breakdown of the organisation of care is becoming predominant.

Prognostic value of TP53 transcriptional activity on p21 and bax in patients with esophageal squamous cell carcinomas treated by definitive chemoradiotherapy.

PURPOSE: The aim of this study was to evaluate biologic factors on survival and clinical response after definitive concomitant chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma (ESCC). METHODS AND MATERIALS: TP53 protein hyperexpression (immunochemistry [IHC]) and functional assay (FA) of TP53, measuring the ability of TP53 to transactivate p21 and bax reporter systems, were performed in patients with ESCC treated by CRT. The impact of parameters studied on survival and clinical response to CRT was assessed. RESULTS: Thirty-eight patients with ESCC were included. TP53 alterations were detected in 84.2% of cases with FA. All TP53 mutations abolished the transactivation of p21 and bax reporter systems. After CRT, complete response rate was 55.3%. The median survival of the population was 17.5 months. Serum albumin (p = 0.002), weight loss <10% (p = 0.005), and response to treatment (p < 0.001) were significantly linked with survival. TP53 alteration in FA was not significantly predictive of response to CRT (p = 0.132) nor survival (p = 0.154). CONCLUSIONS: Our results suggest that wild-type TP53 in ESCC could be associated with good response to definitive CRT. However, the small rate of ESCC with wild-type TP53 suggests that systematic determination of TP53 status is not appropriate for the management of the ESCC population.