The bifocal strategy. A new model for flexible liaison between departments of somatic medicine and psychiatrists or psychologists.

A discrepancy exists between what is known about those conditions which are termed today in the DSM-IV somatizations or somatoform disorders and the fact that only 1-10% of the patients classified in these categories are seen by a psychiatrist or psychologist. Much is however at stake, considering the discomfort of these conditions, their complications (e.g. acute attacks of bronchial asthma, myocardial infarction) and their high cost to society. The bifocal strategy, used experimentally for more than 16 years on a group of 180 patients, belongs to the ambit of liaison psychiatry. It is marked by a practical concern to defuse the process of somatization. This strategy has proved useful from several points of view, as it has enabled: the design of a simple but efficient model for close collaboration between the somatic practitioner and the liaison psychiatrist; the defusing, in an appreciable proportion of cases, of the somatization process; a significant contribution to be made to health-care policy in Belgium, with official recognition and renewed status being accorded to liaison psychiatry.

Centration of intraocular lenses with circular haptics.

PURPOSE: To evaluate two intraocular lens (IOL) models with a circular haptic configuration designed to better distribute forces within the capsular bag over 360 degrees. SETTING: University and Maria Middelares hospitals, Antwerp, Belgium. METHODS: Two IOLs with circular haptics were evaluated for 6 months after implantation: a one-piece, all-poly(methyl methacrylate) (PMMA), Corneal IS M 5.5 lens with a 5.5 mm biconvex optic, overall diameter of 9.8 mm, and two semicircular open haptics (n = 103); a plano-convex, all-PMMA, modified Anis lens with a 5.5 mm plano-convex optic, total diameter of 10.0 or 11.0 mm (depending on diopter), and closed-loop haptics (n = 335). All lenses were inserted through a 5.5 mm scleral incision after phacoemulsification and placed in the capsular bag through a 4.5 mm curvilinear capsulorhexis. The IOLs centered without being rotated. RESULTS: Six months after implantation, the IOL optics were well centered, even in eyes with an eccentric capsulorhexis (19%). In two eyes with partial zonulysis and in seven with posterior capsule rupture, decentration of less than 0.5 mm was observed. Both lenses provided uniform capsular support without causing stress lines in the posterior capsule. There were no cases of capsule contraction syndrome. Posterior capsule fibrosis reducing visual acuity occurred in 4% of eyes in both series. CONCLUSION: The Corneal IS M 5.5 and the Anis lens with circular haptics prevented late optic decentration and, therefore, would be useful in cases of eccentric capsulorhexis, partial zonulysis, anterior radial tears, and posterior capsule rupture. These IOLs may also prevent capsular contraction.

Multiple evanescent white dot syndrome (MEWDS).

We describe the course of MEWDS (multiple evanescent white dot syndrome) in 2 young females. The first patient presented with a very pronounced macular edema. The second patient had merely optic disc edema. Both had an enlargement of the blind spot, which normalized later. Only the granular aspect of the fovea persisted in the involved eye.

[The body as hostage of the self. Phenomenological aspects of anorexia nervosa]. / Le corps otage de soi. Aspects phénoménologiques de l'anorexie mentale.

There are several basic structures upon which anorexia nervosa could develop: hostility between mother and daughter, feministic protest, abandonnism, the ascetic structure, the reluctance against the being-thrown-on-the-world, asw. The phenomenological analysis reveals, through these different structures, a common distress. The patient feels the others, and also, the existence, as a violence. Yet, she feels help ass in her fight against this violence. So she takes her own body as hostage in order to delay her entry in the existence.

Scalp defect associated with postaxial polydactyly: confirmation of a distinct entity with autosomal dominant inheritance.

The association of postaxial polydactyly type A and congenital scalp defect in a 15-year-old severely mentally retarded male confirms the previously reported suggestion that the combination of both anomalies represents a new distinct entity with autosomal dominant inheritance and variable expression.