[Mindfulness-based-relapse prevention (MBRP): Evaluation of the impact of a group of Mindfulness Therapy in alcohol relapse prevention for alcohol use disorders]. / Résultats préliminaires d'un groupe de pleine conscience (Mindfulness) chez des patients alcoolo-dépendants.

UNLABELLED: For several years, the learning of mindfulness has developed in a psychological intervention perspective, particularly in the field of addiction. Presently, the management of addictions with substances is centered on two questions: the motivation in the change of behaviour and in a significant change in alcohol consumption. Concerning alcohol dependence, the evolution of behaviour is variable and characterized by forgiveness episodes and relapses. Over many years, a treatment for the abuse of substance associated with techniques based on full consciousness (Kabat-Zinn, 1990; Segal et al., 2002) Mindfulness-based relapse prevention (MBRP) was developed by Marlatt et al. (2011). The prevention of the relapse therapy, based on full consciousness, is a program of eight sessions integrating techniques of "mindfulness" into the techniques of prevention of the relapse. However, not much research has focused on the MBRP, the publication of the manual regarding this intervention is too recent (Bowen S et al., 2011). OBJECTIVE: We are interested in the active mechanisms, which are at stake in the MBRP. Indeed, the meditation acts presents many mechanisms in the addicting disorders. Our non-controlled research was based on a protocol in order to evaluate the alcohol consummation, mindfulness, impulsiveness, automatic thoughts, anxiety and abilities to cope. The first results are interesting: reduction of alcohol consummation, increase of mindfulness, reduction of trigger relapse, increasing cognitive flexibility and high degree of satisfaction among participants. METHODOLOGY: An intervention MBRP was proposed to 26 patients who were assigned to three groups. They were questioned about their alcohol consumption and assessed by a protocol of seven evaluations before and after the group MBRP: Five Facets Mindfulness (FFMQ), Impulsive Behavior Scale (UPPS), Acceptance and Action Questionnaire (AAQ II), State Trait Anxiety Inventory (STAI-A, STAI-B), Questionnaire of the automatic thoughts (QPA), and The Drug-Taking Confidence Questionnaire (DTCQ-8). This study exposes the preliminary results of an intervention for substance use disorders called mindfulness-based relapse prevention (mbrp) administered to five groups of alcohol dependent patients in a psychiatric department and a department of alcohol science in France. RESULTS: The results show maintained abstinence and a moderation leading to abstinence for the still consuming patients. According to our evaluations, we obtained several significant results after the therapy, despite our small cohort: patients accepted their thoughts and feelings better (FFMQ-judgment); the tendency to give in to the impulses decreased (urgency-UPPS), and their tolerance to anxiety increased (STAI-YA-YB). Moreover, this study appears to confirm that the MBRP program allows an improvement of self-efficiency. The study continues in order to confirm these results on a larger sample and to explore the long-term results, so as to propose a new work-tool for patients and caregivers.

Evidence for the involvement of (Cu-ATP)2- in the inhibition of human erythrocyte (Ca2+ + Mg2+)-ATPase by copper.

The effects of copper on the activity of erythrocyte (Ca2+ + Mg2+)-ATPase have been tested on membranes stripped of endogenous calmodulin or recombined with purified calmodulin. The interactions of copper with Ca2+, calmodulin and (Mg-ATP)2- were determined by kinetic studies. The most striking result is the potent competitive inhibition exerted by (Cu-ATP)2- against (Mg-ATP)2- (Ki = 2.8 microM), while free copper gives no characteristic inhibition. Our results also demonstrate that copper does not compete with calcium either on the enzyme or on calmodulin. The fixation of calmodulin on the enzyme is not altered in the presence of copper as shown by the fact that the dissociation constant remains unaffected. It may be speculated that (Cu-ATP)2- is the active form of copper, which could plausibly be at the origin of some of the pathological features of erythrocytes observed in conditions associated with excess copper.

Aneurysmal bone cyst in the sphenoid bone: treatment with minimally invasive surgery.

Aneurysmal bone cysts are vascular lesions that destroy and expand bone. We report a recently treated case of an aneurysmal cyst of the sphenoid bone. A 14-year-old girl presented with frontal headaches, bouts of nausea, and vomiting. Computed tomography and magnetic resonance imaging showed typical features of an aneurysmal bone cyst. Arterial embolization was undertaken before surgery. The endoscopic transnasal procedure used allowed the complete removal of the aneurysmal bone cyst. This use of minimally invasive surgery makes this case of interest to surgeons of the skull base and sinuses.

[Multiple skin and mouth squamous cell carcinomas related to long-term treatment with hydroxyurea]. / Carcinomes cutanés et buccaux multiples après traitement par l'hydroxyurée.

INTRODUCTION: Cutaneous side-effects of hydroxyurea treatment are frequently observed. Squamous cell carcinomas are the most severe among them. We report a patient with skin and mouth carcinomas after hydroxyurea treatment. To the best of our knowledge, this is the first case reported. OBSERVATION: A 83-year-old woman had been treated with hydroxyurea from 1985 to 1998 for polycythemia vera. She was referred to our institution in 1998 for painful erosions of both hands. Clinical examination revealed a squamous cell carcinoma leading to amputation of a finger. Hydroxyurea was stopped at this time, and the patient underwent treatment with pipobroman. From May 1998 to March 2000, the patient developed numerous skin keratoses and four squamous cell carcinomas on both hands. In September 2000 and October 2000, two additional skin carcinomas and two mouth carcinomas were diagnosed. DISCUSSION: Cutaneous carcinomas are severe side effects of hydroxyurea therapy. They usually occur after several years of treatment and their outcome may be lethal. The chronology and clinical signs are in favour of implicating hydroxyurea in the development of skin and mouth carcinomas. Despite a bibliographic research using Medline and Embase data bases, we could not find another case-report with simultaneous occurrence of skin and mouth carcinomas after hydroxyurea therapy. This observation emphasizes the need of a long term follow-up in patients receiving hydroxyurea.

[Contribution of echography in the detection of lymph node diseases in epidermoid carcinoma of the larynx: therapeutic implications]. / Apport de l'échographie à la détection des adénopathies dans les carcinomes epidermoïdes du larynx et de la margelle: implications thérapeutiques.

Based on a clinical, echographic and histologic study of 80 lymph node dissection, correlations were made by dissection and lymph node localization. The literature and the results of this study suggest that preoperative echography could have an effect on the surgical procedure, especially in cases with a clinically detected lymph node enlargement and if complementary radiotherapy is planned.

[Recurrent or familial facial palsy. Apropos of 6 cases and review of the literature]. / La paralysie faciale périphérique récidivante ou familiale. A propos de 6 cas et d'une revue de la littérature.

About 5 cases of recurrent facial palsy (1 case of familial récurrent facial palsy) and 1 case of non récurrent familial facial palsy, this work analyse the recent knowledges about this subject. Frequency of recurrent palsy is about 10% of the non traumatic facial palsies. A classification is proposed. The prognostic of a recurrence appears similar to the first palsy. Transmission of familial facial palsy seems autosomic dominant or multifactorial. Among the etiology, some like the alternobaric facial paralysis or Melkerson-Rosenthal syndrome could require special preventive or specific therapy.

[Exposure of the facial nerve in the masseteric region during parotid surgery. Technical aspects and value]. / Exposition du nerf facial dans la région massétérine lors de la chirurgie parotidienne. Aspects techniques et intérêts.

With an accurate understanding of facial soft-tissue anatomy, deep plane rithydectomy can be performed in safe and precise fashion. We report our experience of 19 cases of parotidectomy using this superficial musculo-aponeurotic system mobilization anterior to the gland. In all cases (two recurrences), it was thus possible to safely expose at least two terminal branches of the lower facial nerve in the masseteric area without jeopardizing the facial nerve. During a second operation for recurrent tumor or in the case of some lesions as inferior and anterior intraglandular cyst, the distant branches of the nerve can be uncovered by a backward dissection. The easiest to identify seems to be the terminal branches in the masseteric area, as it is directly accessible after cutaneous undermining in an area generally not dissected during previous operations and with preserved anatomic relations. In other cases this technique enables one to expose the parotid gland completely and facilitates anterograde facial nerve dissection by its terminal exposure. The superficial musculo-aponeurotic system dissection allows its backward transposition, in the absence of any contraindication, so as to prevent retromandibular depression following a parotidectomy.

[Otogenic thrombosis of the lateral sinus]. / Les thromboses otogènes du sinus latéral.

Otogenic thrombosis of the lateral sinus, which has become rare since the use of antibiotics, nevertheless still poses diagnostic and therapeutic problems. Based on 4 cases treated at the University Teaching Hospital in Tours since 1982, the authors study the various clinical and paraclinical elements in the diagnosis, stressing the value of CT examination using contrast. Management is then proposed in diagramatic form: the indication for surgery depending on the efficacy of antibiotic therapy and internal jugular vein ligation being required in the event of septic emboli manifest cervical signs.

[Normovolemic hemodilution in the treatment of sudden deafness]. / L'hémodilution normovolémique dans le traitement des surdités brusques.

Of a series of 23 patients presenting sudden deafness, treatment by normovolemic hemodilution yielded good results in 17 cases (74%), including 14 excellent results (61%) with constant efficacy on the tinnitus aurium (100%). These results appear overall superior to the 40 to 65% improvements reported in the literature. Nevertheless, comparisons in this area must take into account the very different assessment criteria applied from one series to another. The authors propose using the formula established to assess professional deafness, but taking the other ear as a reference.

Diagnosis of bone and joint infection by leucocyte scintigraphy. A comparative study with 99mTc-HMPAO-labelled leucocytes, 99mTc-labelled antigranulocyte antibodies and 99mTc-labelled nanocolloid.

Fifty-five patients with 60 suspected infections of bones or joints were studied with 99mTc-hexamethylpropyleneaminooxine- (HMPAO-) labelled leucocytes and 99mTc-labelled antigranulocyte antibodies, in part supplemented with 99mTc-labelled nanocolloid. The findings using the different procedures were in good agreement. Apart from in vertebral lesions, a negative scan--even if the radionuclide bone scan is positive--excludes an infection with high probability (sensitivity 94%). The low specificity (57%) is due to positive imaging of various non-infected lesions. Spondylitis usually shows as non-specific cold lesions. A subtraction technique with computer assisted analysis of HMPAO and nanocolloid scans provides a more precise diagnosis of this condition.

Decreased red cell enolase activity in a 40-year-old woman with compensated haemolysis.

A 40-year-old woman splenectomized 17 years previously for hereditary haemolytic anaemia was investigated in our laboratory because of persistent conjunctival subicterus associated with compensated haemolysis. The results of the autohaemolysis and osmotic fragility tests were similar to those usually observed in hereditary spherocytosis. Red cell enzyme assays indicated a decreased amount of kinetically normal enolase. The genetic transmission of this defect could not be established since the only other affected member of the family was the proposita's father who died several years ago after splenectomy for an undefined haemolytic disorder.