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Brest, France

Le Borgne S.,CHRU de Brest
NPG Neurologie - Psychiatrie - Geriatrie

Falls are a frequent phenomenon among the elderly and sometimes fraught with consequences. Some falls question the clinician as to their mental determinism and as for their suicidal intentionality. Certain clinical situations are sometimes in favor of a suicidal initiative of the elderly person through his/her fall. All this makes falls a means of non-verbal communication; when the words are running out, the subject lets go and falls. The suicidal risk increases as the person gets older. The prevention of the suicidal risk involves a screening for nervous breakdown, often under-diagnosed and under-treated. © 2014 Elsevier Masson SAS. Source

Thomas P.,University of Limoges | Chandes G.,University of Limoges | Hazif-Thomas C.,CHRU de Brest
NPG Neurologie - Psychiatrie - Geriatrie

Formal caregivers, elderly residents and families encounter numerous difficulties when an elderly relative is institutionalized in a nursing home. Numerous problems come to light there, linked to the development of different, sometime competitive, logics in two human groups that are unbalanced in terms of power, the family system and the geriatric institution. The loss of meaning is at the core of the moral pain experienced. Feelings of uneasiness lead to unsuitable, unsatisfactory answers when an awkward question is raised. The question of meaning and its elaboration is analyzed in this article using the model of the semiosphere. To give a meaning to the content of what is perceived is as essential for life as biological factors. Developing the meaning of the care provided, favours good treatment of nursing home residents, of their families, and of the nursing staff. In the absence of early implementation of an intersubjective approach, negotiated and accepted by families and the nursing staff, there can be a drift leading to misunderstanding and then to conflict. Geriatricians and psychologists, when their professional independence is respected, are the vehicles of information between and within these semiospheres and they have an essential role in the prevention of this drift. © 2016 Elsevier Masson SAS. Source

Thomas P.,University of Limoges | Chandes G.,University of Limoges | Hazif-Thomas C.,CHRU de Brest
NPG Neurologie - Psychiatrie - Geriatrie

Memory and meaning form an ensemble that gives body to subjectivity. They provide the full range of personal strategies, by organizing forms of life. They establish personality, validating or countering the choices made by individuals on the basis of experience, and they structure the lexicon of emotions through the interplay of different rites and social habits. Meaning and memory are co-determined and co-built throughout life. Meaning supports memory, and in return memory facilitates the access to meaning derived from the environment. The conditions that favor meaning facilitate the work of memory. The dynamics of the processes occurring between meaning and memory are discussed here. Three aspects will be considered, phenomenological, semiotic and neuropsychological, as well as the consequences of cognitive disorders on the interdependence of meaning and memory. The integrative model of memory and its relationship with the meaning given to the environment are presented in this article. © 2016 Elsevier Masson SAS. Source

Brochard S.,CHRU de Brest | Alter K.,U.S. National Institutes of Health | Damiano D.,U.S. National Institutes of Health
Muscle and Nerve

Introduction: We characterized bilateral shoulder strength and the balance of antagonist/agonist muscle pairs in children with brachial plexus palsy (BPP) and with typical development (TD). Methods: In 15 children with unilateral BPP and 11 with TD, bilateral maximal isometric shoulder strength in flexion/extension, internal/external rotation, and abduction/adduction was recorded using a hand-held dynamometer. Correlation between strength and active range of motion were evaluated using the Mallet score. Results: Children with BPP had strength asymmetry in all muscles, whereas children with TD had significant strength asymmetry for flexors and abductors. In children with BPP, extensors and external rotators were the weakest muscles, leading to sagittal and transverse plane muscle imbalances. Higher strength values were related to better active range of motion. Conclusions: This study highlights the importance of documenting shoulder strength profiles in children with BPP which may help predict deformity development. © 2013 Wiley Periodicals, Inc. Source

Payan C.,CHRU de Brest | Payan C.,Laboratoire Of Bacteriologie Virologie Lubem Ea3882

Hepatitis C virus (HCV) infection, with more than 150 million cases in the world, is one of the major causative agent of cirrhosis and hepatocellular carcinoma (60 % of HCC), leading to a high mortality rate (2/3). The aim of this paper is to update the knowledge of HCV and its natural history. HCV is an enveloped virus of about 50 nm from the Flaviviridae family, it specifically contaminates humans by blood contact, it contains a 9.6 kb RNA showing high variability which defines HCV in genotypes (1-6), sub-types (a, b, c⋯) and variants or quasispecies. HCV develops a chronic infection in humans in nearly 80 % of cases due to the lack of host adaptative immunity, the resulting chronic inflammation causes fibrosis in the liver. Its evolution towards cirrhosis and HCC is usually low but high variations have been reported. Rapid evolution is observed depending of the sex (men), age of contamination (after 40), alcohol consumption (over 40 g per day), metabolic steatosis, insulino-resistance, HIV or HBV coinfections. Although no integration of HCV in infected cells can occur, viral proteins may be involved in HCC development such as C and NS5A proteins or NS3 protease, but these HCV variants have to be identified. Source

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