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1.
Soins Pediatr Pueric ; 45(338): 26-31, 2024.
Artigo em Francês | MEDLINE | ID: mdl-38697722

RESUMO

Any premature birth can be traumatic, and a risk factor for the parenting process and the quality of parent-baby interactions. Average prematurity is no exception. It can undermine essential parenting functions, such as availability and sensitivity to the child, and generate interactive dysfunctions within parent-baby dyads. In some cases, it can lead to genuine psychopathological states.


Assuntos
Recém-Nascido Prematuro , Relações Pais-Filho , Poder Familiar , Humanos , Recém-Nascido , Poder Familiar/psicologia , Nascimento Prematuro/psicologia
2.
Soins Pediatr Pueric ; 45(338): 22-25, 2024.
Artigo em Francês | MEDLINE | ID: mdl-38697721

RESUMO

Babies born prematurely are frequently prone to developmental disorders, which are all the more severe in babies of low gestational age. However, medium prematurity also generates its own set of difficulties, including sensory, motor, cognitive, behavioral, relational and emotional disorders. It is essential to gain a better understanding of the developmental trajectory of these children and its various ups and downs, in order to support their development as early as possible.


Assuntos
Deficiências do Desenvolvimento , Recém-Nascido Prematuro , Humanos , Recém-Nascido , Recém-Nascido Prematuro/psicologia , Deficiências do Desenvolvimento/psicologia , Desenvolvimento Infantil
3.
J Fr Ophtalmol ; 47(6): 104187, 2024 Apr 24.
Artigo em Francês | MEDLINE | ID: mdl-38663225

RESUMO

PURPOSE: This article aims to describe the causes of ophthalmological disqualification from the military services detected during specialist consultations conducted at Army Training Hospitals. METHODS: This observational, cross-sectional, multicenter study retrospectively included individuals deemed as "unfit for military service" due to eye diseases identified during the specialist consultation conducted at 3 ATHs between January 2020 and December 2021. The data collected included age, medical and surgical history, reasons for ophthalmological disqualification, uncorrected distance visual acuity, best corrected distance visual acuity and cycloplegic refraction. RESULTS: Over this period, 133 subjects (98 men and 35 women) were included. Thirty-eight candidates (28.6%) were declared unfit due to a refractive error beyond the required limits, including 30 myopic subjects in excess of -10 diopters (D) and 8 hypermetropic subjects over +8 D. Twenty-five candidates (18.8%) were unfit under the age of 21 years due to corneal refractive surgery performed before the required age. Four subjects (3.0%) were unfit due to phakic intraocular lenses. Degenerative conditions were observed in 23 subjects (17.3%), including 21 patients with severe keratoconus. Other causes of incapacity were linked to oculo-orbital trauma in 11 subjects (8.3%), moderate or severe amblyopia in 7 patients (5.3%), congenital causes in 7 subjects (5.3%), inflammatory or infectious diseases in 7 candidates (5.3%), hereditary causes in 6 subjects (4.5%) and undetermined visual dysfunctions in 4 subjects (3.0%). CONCLUSION: The three main causes of ophthalmological disqualification were high ametropia, refractive surgery performed before the required age and keratoconus.

4.
Rev Infirm ; 73(300): 17-19, 2024 Apr.
Artigo em Francês | MEDLINE | ID: mdl-38643993

RESUMO

Severe head trauma, with or without polytrauma, subarachnoid haemorrhage due to aneurysm rupture, is an unexpected tragedy for patients and their families. These accidents are likely to result in extremely serious neurological damage, with many of the patients under our care facing a life-threatening prognosis. To protect the brain, one solution is to put the patient into a deep sleep during the so-called "acute" phase, making it impossible to assess the repercussions of the initial injuries at the time: this is what we call "waiting resuscitation".


Assuntos
Paralisia Cerebral , Ressuscitação , Humanos , Paralisia Cerebral/enfermagem , Ressuscitação/métodos , Ressuscitação/enfermagem
5.
Rev Infirm ; 73(300): 24-26, 2024 Apr.
Artigo em Francês | MEDLINE | ID: mdl-38643996

RESUMO

Cerebrospinal patients are victims of acquired brain lesions of multiple etiologies: head trauma, stroke, brain tumors, arteriovenous malformations, progressive degenerative diseases. Their care requires a combination of neurological, neuropsychological, psychiatric and psychopathological knowledge. Psychological follow-up of patients with cerebral palsy is one of the dimensions of their care.


Assuntos
Paralisia Cerebral , Humanos , Paralisia Cerebral/psicologia , Transtornos Mentais/etiologia , Transtornos Mentais/terapia
6.
J Anal Psychol ; 69(2): 281-297, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38500376

RESUMO

For most residents of Europe, war is a new experience in which they find themselves both as witnesses and participants. In this paper the war in Ukraine serves as an illustration and case example. Like any unfamiliar experience, war elicits profound emotional responses which can be so overwhelming that an individual may be unable to fully process them and to create mental representations of the reality of war. When the psyche becomes entrapped in an unprocessed state, without the capacity to derive meaning from it, this results in the "fossilization" of the psyche akin to what McGinley and Segal describes as a totalitarian state of mind. Subjectivity and individual differences come under collective or personal attack, or both. This state of being prioritizes the needs of the collective psyche over the individual psyche. The image of Gorgon Medusa, who transformed living people into "fossilized" ones, is presented as a metaphor of total identification with the collective dimension. In contrast, the psyche can reveal a creative approach to resolving war-induced trauma. This is depicted in the concept of the Alchemical Stone and its creation, which symbolizes a harmonious connection between the external and internal realms, the subjective and objective experiences, and the real and the imaginal dimension.


Pour la plupart des habitants de l'Europe, la guerre est une nouvelle expérience dans laquelle ils se retrouvent à la fois témoins et participants. Dans cet article, la guerre en Ukraine sert d'illustration et de cas exemplaire. Comme toute expérience qui sort de l'ordinaire, la guerre suscite des réactions émotionnelles profondes qui peuvent être si accablantes qu'un individu peut se trouver incapable de les traiter pleinement et de créer des représentations mentales de la réalité de la guerre. Lorsque la psyché se retrouve piégée dans un état qu'elle ne peut pas traiter, sans la capacité d'en tirer un sens, il en résulte une « fossilisation ¼ de la psyché, semblable à ce que McGinley et Segal a décrit comme un état d'esprit totalitaire. La subjectivité et les différences individuelles font l'objet d'attaques collectives ou personnelles, ou des deux. Cet état d'être donne la priorité aux besoins de la psyché collective plutôt qu'à la psyché individuelle. L'image de la Gorgone Méduse, qui a transformé des êtres vivants en êtres «fossilisés¼, est présentée comme une métaphore de l'identification totale à la dimension collective. En revanche, la psyché peut révéler une approche créative pour résoudre les traumatismes induits par la guerre. Ceci est représenté par le concept de la Pierre Alchimique et de sa création, qui symbolise un lien harmonieux entre les royaumes extérieur et intérieur, les expériences subjectives et objectives, et les dimensions réelles et imaginales.


Para la mayoría de los habitantes de Europa, la guerra es una experiencia nueva en la que se encuentran tanto como testigos y como participantes. En este artículo, la guerra en Ucrania sirve como ilustración y ejemplo de caso. Como cualquier experiencia desconocida, la guerra provoca profundas respuestas emocionales que pueden ser tan abrumadoras que un individuo puede ser incapaz de procesarlas completamente y de crear representaciones mentales de la realidad de la guerra. Cuando la psique queda atrapada en un estado, sin posibilidad de elaborar y sin la capacidad para hallarle un sentido, se produce una "fosilización" de la psique similar a lo que McGinley Segal describe como un estado mental Totalitario. La subjetividad y las diferencias individuales son objeto de ataques colectivos o personales, o ambos. Este estado de ánimo prioriza las necesidades de la psique colectiva sobre la individual. La imagen de la Gorgona Medusa, que transformó a las personas vivas en "fosilizadas", se presenta como una metáfora de la identificación total con la dimensión colectiva. Por el contrario, la psique puede revelar un enfoque creativo para resolver el trauma inducido por la guerra. Esto se representa en el concepto de la Piedra Alquímica y su creación, que simboliza una conexión armoniosa entre los reinos externo e interno, las experiencias subjetivas y objetivas, y las dimensiones real e imaginal.


Assuntos
Mentalização , Humanos , Emoções , Europa (Continente)
7.
J Anal Psychol ; 69(2): 298-322, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38500332

RESUMO

This article aims to present the interdisciplinary project "My Story from Silence", conceived in 2022. The project represents a pioneering effort in assembling individuals from diverse communities, characterized by varying ethnic, national, and migratory backgrounds, along a historically dynamic border. Its primary objective was to provide a platform for these participants to articulate and share narratives previously shrouded in silence, offering insights into their historical pasts. Emphasizing reciprocal dialogue for the first time, the initiative fostered an environment where participants engaged in the dual act of narrating their own experiences and attentively listening to the narratives of others. These memories were explored in group workshops on both sides of the border. By combining elements of cultural anthropology fieldwork and analytical psychology, the workshops attempted to address hitherto unaddressed traumas and silent personal memories linked to major traumatic historical events such as fascism and Istrian exodus through the narratives of individuals. Three vignettes will illustrate the workshop dynamic and our Jungian understanding of it.


Cet article a pour objectif de présenter le projet interdisciplinaire « My Story from Silence ¼ conçu en 2022. Ce projet représente un effort pionnier dans le rassemblement d'individus de diverses communautés, caractérisées par des origines ethniques, nationales et migratoires diverses, le long d'une frontière historiquement dynamique. Son objectif principal était de fournir à ces participants un cadre pour exprimer et partager des récits auparavant enfermés dans le silence, offrant un éclairage sur leur passé historique. En mettant pour la première fois l'accent sur le dialogue réciproque, l'initiative a favorisé un environnement où les participants se sont impliqués dans un double acte; raconter leurs propres expériences et écouter attentivement les récits des autres. Ces souvenirs ont été explorés dans le cadre d'ateliers de groupe, des deux côtés de la frontière. En combinant des éléments de l'anthropologie culturelle de terrain et de la psychologie analytique, les ateliers ont tenté d'aborder des traumatismes jusque­là non traités et des souvenirs personnels silencieux liés à des événements historiques traumatisants majeurs tels que le fascisme et l'exode d'Istrie, à travers les récits d'individus. Trois vignettes illustrent la dynamique de l'atelier et notre compréhension jungienne de celle­ci. Les photographies à la fin de l'article fournissent des images d'une table ronde de clôture et de l'installation in situ dans la vieille ville de Koper­Capodistrie, en Slovénie, une ville bilingue au passé troublé dans la zone contestée de la frontière italo­slovène (ex­Yougoslavie).


Este artículo pretende presentar el proyecto interdisciplinario "Mi Historia desde el Silencio", concebido en 2022. El proyecto representa un esfuerzo pionero por reunir individuos de diversas comunidades, caracterizadas por distintos orígenes étnicos, nacionales y migratorios, a lo largo de una frontera históricamente dinámica. Su principal objetivo era proporcionar una plataforma para que los participantes pudieran articular y compartir narrativas previamente silenciadas, ofreciendo una comprensión de sus pasados históricos. Enfatizando por primera vez un diálogo recíproco, la iniciativa fomentó un entorno en el que los y las participantes se comprometieran tanto en el acto de narrar sus propias experiencias como en el de escuchar atentamente las narrativas de otros. Estas memorias se exploraron en talleres grupales a ambos lados de la frontera. Combinando elementos del trabajo de campo de la antropología cultural y de la psicología analítica, los talleres intentaron ­ a través de los relatos de cada participante ­ abordar traumas hasta entonces no abordados y memorias personales silenciadas vinculadas a importantes acontecimientos históricos traumáticos como el fascismo y el éxodo de Istria. Tres viñetas ilustrarán la dinámica del taller y nuestra comprensión Junguiana de la misma. Las fotografías que aparecen al final del artículo ofrecen imágenes de la mesa redonda de clausura y de la instalación en el casco antiguo de Koper­Capodistria (Eslovenia), una ciudad bilingüe con un pasado turbulento situada en la conflictiva zona fronteriza entre Italia y Eslovenia (antigua Yugoslavia).


Assuntos
Trauma Histórico , Humanos , Psicoterapia
8.
Infant Ment Health J ; 45(3): 276-285, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38343150

RESUMO

In this cross-sectional study performed in Canada, we evaluated the frustration levels of prepartum and postpartum mother and father couple-pairs. Our goal was to determine if there were differences in frustration levels between mothers and fathers while listening to prolonged infant crying, and further, how frustration levels might differ between prepartum and postpartum samples. Using two discrete groups, prepartum (Sample 1; N = 48) and postpartum (Sample 2; N = 44) mother and father couple-pairs completed 600 s of listening to audio-recorded infant cry sounds. Participants continuously reported their subjective frustration using a computerized Continuous Visual Analog Scale (CVAS). There was no significant difference in frustration responses between mothers and fathers across both prepartum and postpartum samples. Postpartum mothers and fathers experienced greater frustration than their prepartum counterparts, and frustration increased faster in postpartum couples compared to prepartum couples. Informing first-time parents of the universal experiences of frustration to prolonged crying bouts that are characteristic of their infant's early weeks of life may lead to greater understanding towards their infant, and perhaps decreased instances of harmful responses.


En este estudio transeccional, evaluamos los niveles de frustración de las parejas de mamás y papás antes y después del parto. Nuestro propósito fue determinar si hay diferencias entre mamás y papás en cuanto a los niveles de frustración mientras escuchan el prolongado llanto del infante, y cómo los niveles de frustración pudieran diferir entre grupos­muestra antes y después del parto. Usando dos grupos discretos, antes del parto (grupo­muestra 1; N = 48) y después del parto (grupo­muestra 2; N = 44), las parejas de mamás y papás completaron 600 segundos escuchando sonidos grabados en audio de llanto de infante. Los participantes continuamente reportaron su frustración subjetiva usando una escala análoga visual continua computarizada (CVAS). No hubo diferencia significativa en las respuestas de frustración entre mamás y papás a lo largo de los grupos­muestra tanto antes del parto como después del parto. Las mamás y papás en el grupo­muestra después del parto experimentaron mayor frustración que sus homólogos en el grupo­muestra antes del parto, y la frustración aumentó más rápido en las parejas del grupo­muestra después del parto tal como se les comparó con las parejas del grupo­muestra antes del parto. Estos resultados sugieren que las parejas primíparas posterior al parto están más propensas a experimentar considerables cantidades de frustración como respuesta al llanto del infante después que el bebé ha nacido. Informarles a los progenitores primerizos acerca de las experiencias generales de la frustración a los prolongados ataques de llanto que son característicos de las primeras semanas de vida de su infante pudiera llevar a una mayor comprensión hacia su infante y quizás disminuir las instancias de respuestas dañinas.


Dans cette étude transversale nous avons évalué les niveaux de frustration des couples­paires mère et père avant et après la naissance. Notre but était de déterminer s'il existe des différences entres les mères et les pères dans leurs niveaux de frustration en entendant des pleurs de bébé prolongés et de quelle manière les niveaux pourraient différer entre les échantillons avant la naissance et après la naissance. En utilisant deux groupes discrets, avant la naissance (Echantillon 1; N = 48) et après la naissance (Echantillon 2; N = 44) les couples­paires mère et père ont écouté 600 seconds d'enregistrements de pleurs de bébés. Les participants ont fait état de leur frustration subjective en utilisant une échelle analogique visuelle continue informatisée (CVAS). Il s'est avéré n'y avoir aucune différence importante dans les réactions de frustration entre les mères et les pères au travers des échantillons à la fois avant l'accouchement et après l'accouchement. Ces résultats suggèrent que les coupes postpartum primipares sont plus à même de faire l'expérience de niveaux élevés de frustration en réaction aux pleurs du bébé une fois le bébé arrivé. Informer les parents qui sont parents pour la première fois des expériences universelles de frustration aux crises de pleurs prolongées qui caractérisent les premières semaines de la vie des bébés peut mener à une plus grande compréhension de leur bébé et peut­être à une baisse des case d réactions néfastes.


Assuntos
Choro , Pai , Frustração , Mães , Período Pós-Parto , Humanos , Choro/psicologia , Feminino , Masculino , Adulto , Pai/psicologia , Período Pós-Parto/psicologia , Estudos Transversais , Mães/psicologia , Lactente , Gravidez , Canadá , Adulto Jovem , Recém-Nascido
9.
Rev Infirm ; 73(297): 30-31, 2024 Jan.
Artigo em Francês | MEDLINE | ID: mdl-38242619

RESUMO

The essential place of the psychologist in the orthopedics department of Pitié-Salpêtrière is to relieve the suffering of polytraumatized patients, to work in a multidisciplinary manner, to participate in the staff of the department to have complete information of the patients, to give an informed opinion on the psychological state of the patient, so as to help in the discussion for making decisions on their trajectory. The role of the psychologist is part of the overall care of patients, care which sometimes extends to the family, the patient's loved ones and the teams who care for them.


Assuntos
Traumatismo Múltiplo , Ortopedia , Psicologia , Humanos , Traumatismo Múltiplo/psicologia
10.
Can J Occup Ther ; 91(2): 124-135, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38146163

RESUMO

Background. Public safety personnel (PSP) are frequently exposed to psychological trauma through their work. Evidence shows that worker's compensation claims for work-related psychological injuries are on the rise for PSP. Occupational therapists increasingly provide return to work (RTW) services for this population. Purpose. To explore the therapeutic practices and personal experiences of occupational therapists working with PSP who have work-related psychological injuries. Method. This mixed methods descriptive study included a chart review of available occupational therapy client records from 2016 to 2020 for PSP with work-related psychological injuries from two Ontario companies. Additionally, a web-based self-report survey for Ontario occupational therapists providing RTW services to this same population was available from November 1, 2021 to June 1, 2022. Findings. The chart review included 31 client records and the online survey was completed by 49 Ontario occupational therapists. Therapists commonly provided services in clients' homes, workplaces, and communities, and focused on functional activities. The evidence base drawn on by therapists was not always occupation-based. Barriers to RTW included challenges with interprofessional collaboration, stigma, and the COVID-19 pandemic. Implications. Occupational therapists are commonly working with PSP with work-related psychological injuries and have the opportunity to contribute to the evidence base for occupational approaches to RTW.


Assuntos
Terapia Ocupacional , Retorno ao Trabalho , Humanos , Terapia Ocupacional/organização & administração , Retorno ao Trabalho/psicologia , Ontário , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , COVID-19/reabilitação , Terapeutas Ocupacionais/psicologia
11.
West Afr J Med ; 40(12 Suppl 1): S42, 2023 Dec 04.
Artigo em Francês | MEDLINE | ID: mdl-38071486

RESUMO

Introduction: Ce fait clinique met en relief la profondeur d'une atteinte psychique en recomposition avec la vulnérabilité du genre, l'isolement professionnel, la religion et la culture où l'espace et le temps perdent totalement leur valeur. Observation: Occupant un poste de surveillance des chemins des braconniers très élongés avec une communication défaillante par moment, une jeune femme nourrice forestière à plusieurs fois fait des observations sur la dangerosité et l'absence de défense en cas d'attaque de ces positions professionnelles. Un petit matin, elle est retrouvée par hasard par un chasseur totalement baignant dans son sang avec des multiples coupures de coupe-coupe. Elle se réveille après 25 jours de coma et plus de trois séances de kinésithérapie sans aucune communication verbale. Arrivé en entretien chez le psychiatre, elle a un regard hagard avec une torpeur. Elle finit à la deuxième séance par s'interroger de la raison de la présence dans ce lieu au premier contact avec son enfant qu'elle considère au paradis. Seul l'instinct maternel, l'a fait sortie de son état quasi indescriptible après le trauma psychique. Conclusion: Il est impératif aux professionnels de la santé des corps utilisateurs des armes à feu d'être attentif à la souffrance psychique en relation avec le genre et les conditions culturelles. Mots clés: Psycho-traumatisme, Genre, Insécurité, Afrique subsaharienne.

12.
J Anal Psychol ; 68(5): 869-893, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37767899

RESUMO

In this paper, I will explore the role of art-making, the experience of trauma and dissociation, and the process of working with self-states from an analytic and creative frame. Relevant literature on dissociation, trauma, and the use of art will be discussed. A case involving my work with an adolescent girl who had experienced sexual abuse from a family member will be shared, with an emphasis on the meaningful role images played during the therapeutic process. Both Jungian and psychoanalytic models of conceptualizing and working with dissociation are included, following Donald Kalsched's (2013) recommendation for a "binocular stance" to treatment, including both a focus on the inner, intrapsychic world and the interpersonal, relational realm, and how art images both illuminated and expressed these realms. Within the therapeutic process, art images allowed the therapist a view into the client's unconscious process, and created a meeting ground for dissociative barriers to be gradually seen, felt and known, by both therapist and client. The experience of dissociation, in images and in session, provided a reference point for myself and my client, Taylor, to develop a shared understanding and a framework for growth.


Dans cet article, j'explorerai le rôle de la création artistique, l'expérience du traumatisme et de la dissociation, et le processus de travail avec les états liés au soi, ceci à partir d'un cadre analytique et créatif. La littérature se rapportant à la dissociation, au traumatisme et à l'utilisation de l'art sera étudiée. Un cas concernant mon travail avec une adolescente qui a été victime d'abus sexuels par une personne de sa famille sera partagé, en mettant l'accent sur le rôle significatif que les images ont joué au cours du processus thérapeutique. Les modèles jungiens et psychanalytiques de conceptualisation et de travail avec la dissociation sont pris en compte, suivant la recommandation de Donald Kalsched (2013) pour une « position binoculaire ¼ dans le traitement - mettre l'accent à la fois sur le monde intérieur et intrapsychique et sur le domaine relationnel interpersonnel - et comment les images issues de l'art ont à la fois éclairé et exprimé ces domaines. Dans le processus thérapeutique, les images artistiques ont donné au thérapeute un accès au processus inconscient du client et ont créé un terrain de rencontre pour que les barrières dissociatives soient progressivement vues, ressenties et connues par le thérapeute et le client. L'expérience de la dissociation, en images et en séance, a fourni un point de référence pour mon client, « Taylor ¼, et pour moi-même afin de développer une compréhension commune et un cadre de travail pour la croissance.


En este artículo, exploraré el rol de la creación artística, la experiencia del trauma y la disociación, y el proceso de trabajar con los estados del self desde un marco analítico y creativo. Se discutirá la literatura relevante sobre disociación, trauma y el uso del arte. Se compartirá un caso de mi trabajo con una adolescente que había sufrido abusos sexuales por parte de un familiar, haciendo hincapié en el papel significativo que desempeñaron las imágenes durante el proceso terapéutico. Se incluyen modelos tanto junguianos como psicoanalíticos de conceptualizar y trabajar con la disociación, siguiendo la recomendación de Donald Kalsched (2013) de una "postura binocular" para el tratamiento, incluyendo tanto un enfoque en el mundo interno, intrapsíquico, como en la dimensión interpersonal, relacional, y en cómo las imágenes de arte iluminaron y expresaron estas áreas. Dentro del proceso terapéutico, las imágenes artísticas permitieron al terapeuta una visión del proceso inconsciente del cliente y crearon un punto de encuentro para que las barreras disociativas fueran vistas, sentidas y conocidas gradualmente, tanto por el terapeuta como por el cliente. La experiencia de la disociación, en imágenes y en sesión, proporcionó un punto de referencia para mí y para mi cliente, "Taylor", para desarrollar una comprensión compartida, y un marco de referencia para el crecimiento.


Assuntos
Psicanálise , Psicoterapia , Feminino , Humanos , Adolescente , Relações Interpessoais
13.
Neurochirurgie ; 69(6): 101487, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37696447

RESUMO

PURPOSE: Several studies have confirmed that external ventricular drain decreases intracranial pressure (ICP) after traumatic brain injury (TBI). Considering its impact on ICP control and cerebral waste metabolites clearance, timing of external ventricular drain (EVD) insertion could improve CSF drainage efficiency. The aim of the study was to evaluate the impact of early EVD versus a later one on the 3-month outcome. METHODS: For this retrospective cohort study conducted in two regional trauma-center (Caen CHU Côte de Nacre and Beaujon Hospital) between May 2011 and March 2019, all patients with intracranial hypertension following TBI and treated with EVD were included. We defined the early EVD by drainage within the 24 h of the hospital admission and the late EVD insertion by drainage beyond 24 h. A poor outcome was defined as a Glasgow Outcome Scale of one or two at 3 months. RESULTS: Among the cohort of 671 patients, we analyzed 127 patients. Sixty-one (48.0%) patients had an early insertion of EVD. In the early EVD group, the mean time to insertion was 10 h versus 55 h in the late EVD group. Among the analyzed patients, 69 (54.3%) had a poor outcome including 39 (63.9%) in the early group and 30 (45.5%) in the later one. After adjustment on prognostic factors, early EVD insertion was not associated with a decrease in a poor outcome at 3-months (OR = 1.80 [0.73-4.53]). CONCLUSION: Early insertion of EVD (<24 h) for intracranial hypertension after TBI was not associated with improved outcome at 3 months.


Assuntos
Lesões Encefálicas Traumáticas , Hipertensão Intracraniana , Humanos , Estudos Retrospectivos , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/cirurgia , Drenagem , Hipertensão Intracraniana/etiologia , Hipertensão Intracraniana/cirurgia , Pressão Intracraniana
14.
Prog Urol ; 33(10): 469-473, 2023 Sep.
Artigo em Francês | MEDLINE | ID: mdl-37634959

RESUMO

INTRODUCTION: Post-traumatic rupture of the posterior urethra is a serious injury that can compromise the micturition and erectile prognosis of the often-young patient. The management of this lesion is still controversial, leaving the choice between early endoscopic realignment or suprapubic catheterization with deferred urethroplasty. The objective of this study was to report our clinical experience and outcomes with early endoscopic realignment (EER) for patients with pelvic fracture urethral injury. PATIENTS AND METHODS: We underwent a retrospective review of patients with pelvic fracture associated urethral injury who underwent EER from 2010 to 2020. Preoperative, perioperative, and postoperative outcome data were collected. Complications for the surgical procedure were analyzed, as well as postoperative stenosis, urinary incontinence and erectile dysfunction. The primary endpoint was success, defined as satisfying micturition with no urethral stricture at the time of last follow-up. RESULTS: Early endoscopic realignment was performed in 26 patients managed for complete post-traumatic posterior urethral rupture. The median age was 26 (16-39) years. The most common mechanism of urethral injury was road traffic accidents in 69.23% of cases. The most common urethral injury was grade 4 in 23 patients (88.46%). The median time to endoscopic realignment was 8 days (3-18). The median time to postoperative bladder catheterization was 22 (10-32) days. The median follow-up time was 34 (18-54) months. Ten patients developed urethral stricture during follow-up: 7 (26.92%) were treated with one or two internal cold blade urethrotomies, 3 required urethroplasty. There were no urethroplasty failures after a first endoscopic realignment. Two patients reported severe stress urinary incontinence. The median IIEF-5 score at the date of last news was 23 (17-25). CONCLUSION: Early endoscopic realignment allows some patients to avoid a heavier surgical treatment, and doesn't compromise the realization of a later urethroplasty.


Assuntos
Fraturas Ósseas , Estreitamento Uretral , Masculino , Humanos , Adulto , Constrição Patológica , Endoscopia , Estreitamento Uretral/etiologia , Estreitamento Uretral/cirurgia , Uretra/cirurgia
15.
Biol Aujourdhui ; 217(1-2): 35-38, 2023.
Artigo em Francês | MEDLINE | ID: mdl-37409862

RESUMO

This article is a brief Introduction to a series of articles issued from the Journée Claude Bernard, organized at the Académie Nationale de Médecine. This session had for thematic "Memory and traumatism" and was composed of presentations coming from different disciplines including biological sciences and humanities. Several publications come from the Programme 13-Novembre, devoted to a traumatic event in French society - the attacks of 13 November 2015 in Paris and its immediate suburbs - and its consequences on the construction of individual and collective memories of this tragic event.


Title: Mémoire et traumatisme : de la biologie aux sciences sociales. Abstract: Cet article est une brève Introduction à une série d'articles issus de la Journée Claude Bernard, organisée à l'Académie Nationale de Médecine le 24 novembre 2021. Cette Journée, dont le thème était « Mémoire et traumatisme ¼, avait pour originalité de présenter des travaux provenant de disciplines différentes allant des sciences biologiques aux sciences humaines et sociales. Plusieurs publications s'appuient sur le Programme 13-Novembre, qui envisage les conséquences des attentats du 13 novembre 2015 sur la construction des mémoires individuelles et collectives de cet événement dramatique.


Assuntos
Biologia , Ciências Humanas , Humanos
16.
Biol Aujourdhui ; 217(1-2): 55-64, 2023.
Artigo em Francês | MEDLINE | ID: mdl-37409865

RESUMO

Post-Traumatic Stress Disorder (PTSD) is a disorder that develops following the experience of a highly stressful event, which involves a confrontation with death or the threat of death, serious injury or sexual violence. It is characterized by symptoms such as intrusions, avoidance and hypervigilance. According to the literature, PTSD is associated with an imbalance between a privileged memorization of the emotional and sensory aspects of the traumatic event and a failure to memorize the contextual aspects. That is why PTSD is now considered a memory disorder whose effects extend to several components. In this review article, we focus on how PTSD affects long-term memory. The first part describes the long-term effects of PTSD on episodic memory with emphasis on the difficulties in encoding certain elements of the traumatic event and their consequences. These difficulties may be manifested in the narration of the trauma, with a discourse of the traumatic event lacking in contextual details. They may also lead to reliving and generalizing the fear to other contexts, whether they are related to the trauma or not. The second part of the article discusses how PTSD affects autobiographical memory and has consequences for the construction of identity and the perception of the past, present and future of people with this disorder. Autobiographical memory, which plays a key role in the storage of past personal memories as well as in identity formation, shows several forms of disruption induced by PTSD. First, a decrease in contextual details associated with memories of the personal past is observed, meaning that people with PTSD tend to remember their past experiences less accurately. Second, a propensity to project the future in a more negative and unpredictable manner is evidenced, related to a feeling of uncertainty about the future in PTSD suffering individuals. Finally, alterations in the encoding of present events due to the disruptive effects of post-traumatic stress symptoms during the encoding process are also identified.


Title: Les altérations de la mémoire dans le trouble de stress post-traumatique. Abstract: Le Trouble de Stress Post-Traumatique (TSPT) est une pathologie qui se développe chez une personne qui a fait l'expérience d'un événement hautement stressant impliquant une confrontation à la mort ou à une menace de mort, à une blessure grave ou à des violences sexuelles. Ce trouble se caractérise par plusieurs symptômes dont les intrusions, l'évitement et l'hypervigilance. Le TSPT est associé à un déséquilibre entre une mémorisation exacerbée des aspects émotionnels et sensoriels de l'événement traumatique et un défaut de mémorisation des aspects contextuels. En conséquence, le TSPT est aujourd'hui considéré comme un trouble de la mémoire dont les retentissements s'étendent à plusieurs de ses composantes. Cet article expose les conséquences du TSPT sur la mémoire à long terme et met la focale sur deux mécanismes : l'encodage partiel de l'événement traumatique en mémoire épisodique et l'influence de cette expérience traumatique sur les souvenirs personnels en mémoire autobiographique. L'article aborde en première partie les difficultés d'encodage de certains éléments de l'événement traumatique et leurs conséquences, comprenant les reviviscences ainsi que la persistance et la généralisation de la peur à d'autres contextes plus ou moins liés à l'événement traumatique. La deuxième partie aborde la façon dont le trouble affecte la mémoire autobiographique et l'identité en occasionnant une réduction de la précision des événements du passé, des altérations de la capacité à se projeter dans des événements futurs et un encodage incomplet de nouveaux événements.


Assuntos
Memória , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia
17.
Hand Surg Rehabil ; 42(4): 365-368, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37356570

RESUMO

The radial nerve conveys sensory and motor information to and from the upper limb, and radial nerve injury can induce functional disability, as demonstrated by the case of the renowned French writer Louis-Ferdinand Céline (1894-1961), who sustained a gunshot injury to his right arm in October 1914. Radial nerve injuries treated during World War I inspired the publication of several medical handbooks and medical theses, such as that of the military surgeon Major Robert Bretton (1889-1956). The aim of this paper is, via Céline's injury, to explore the management of radial nerve injury during and since World War I. It is important to consider the historical perspective in order to improve radial nerve injury management so as to adapt to modern warfare.


Assuntos
Nervo Radial , Cirurgiões , Humanos , I Guerra Mundial , Guerra , Extremidade Superior/cirurgia
18.
Soins ; 68(874): 46-50, 2023 Apr.
Artigo em Francês | MEDLINE | ID: mdl-37127390

RESUMO

Faced with the unthinkable of death, caregivers mobilize their psychological defenses, but sometimes these are overwhelmed. The impact of a patient's death depends on the patient's singularity, the resonance of his or her history, and the way he or she was cared for. Confronted with deaths without being able to represent them, professionals can be overwhelmed, experience anxiety and depression, or reach professional exhaustion. The creation of collective spaces to represent the death of patients allows for the co-construction of meaning and the mobilization of resources.


Assuntos
Ansiedade , Cuidadores , Humanos , Masculino , Feminino , Cuidadores/psicologia
19.
Hand Surg Rehabil ; 42(5): 413-418, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37217077

RESUMO

OBJECTIVES: There is growing evidence of cognitive impairment after traumatic peripheral lesions. The purpose of this study was to explore the association between cognitive function and traumatic upper-limb injury. We assessed difference in cognitive function between participants with and without upper-limb injury, and explored the association between cognitive function and certain variables in injured individuals: gender, age, body mass index (BMI), educational level, and occupation. We sought to identify the factors associated with cognitive function in injured subjects: time since injury, injury side, nerve injury, hand function, pain, and finger sensation. MATERIAL AND METHODS: A cross-sectional observational study was conducted, with 2 groups: observational group (with traumatic upper-limb injury) and control group (uninjured). The 2 groups were matched for age, gender, BMI, educational level and occupation. Short-term memory and executive functions were assessed using the Rey Auditory and Verbal Learning Test (RAVLT) and Stroop Color and Word Test (SCWT), respectively. RESULTS: 104 participants with traumatic upper-limb injury and 104 uninjured control subjects were included. There was a significant inter-group difference only in RAVLT (p < 0.01; Cohen d, of 0.38). Regression analysis demonstrated an association of pain on VAS (beta = -0.16, p < 0.01) and touch-test (beta = 1.09, p < 0.05) with total RAVLT score (short-term memory) in injured subjects (R2 = 0.19, F (2, 82) = 9.54, p < 0.001). CONCLUSION: Traumatic upper-limb injury can impact short-term memory, which should be kept in mind during rehabilitation.


Assuntos
Traumatismos do Braço , Cognição , Humanos , Estudos Transversais , Testes Neuropsicológicos , Função Executiva/fisiologia , Extremidade Superior
20.
Soins Pediatr Pueric ; 44(331): 52-55, 2023.
Artigo em Francês | MEDLINE | ID: mdl-37024184

RESUMO

If the child witness does not suffer physical violence in his flesh, growing up in a context of conjugal violence is not without damage for his subjective construction. The violence frightens them, makes them anxious and insecure, and confronts them with the question of death, which cannot be represented or symbolized. Trauma and a possible identification with the aggressor are born from this. Violence affects the toddler in his investments and in the links he weaves with his parents. Parents, whose protective maternal function is weakened and whose paternal function is failing.


Assuntos
Violência Doméstica , Masculino , Humanos , Pai
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