CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

Trus prostate biopsies pierced area can impact cancer rate detection

International audienc

Systematic prostate biopsies may detect mor insignificant cancer than mri lesion target prostate biopsies

International audienc

Comparison between systematic and mri tergeted prostate biopsy for patient with no history of prostate cancer attending a first round of trans-rectal ultrasound biopsy procedure

International audienc

Corps des foetus mort-nés

Une décision judiciaire de 2008 concernant les « enfants nés sans vie » souligne que « tout fœtus né sans vie, à la suite d’un accouchement, peut être inscrit sur les registres de décès de l’état civil ». Elle a révélé que la prise en charge des fœtus morts est devenue une question de société et de droits pour les couples. La reconnaissance conférée à « l’enfant » mort in utero entraîne certes une nécessité d’accompagnement des parents mais suscite aussi des interrogations pour les professionnels de santé. Cette évolution pose la question de la place à donner au fœtus mort sans tomber dans des positions idéologiques sur la reconnaissance du fœtus en tant que personne. Elle permet de s’interroger également sur les priorités de santé publique, à un moment où, si le deuil parental est reconnu, aucun registre épidémiologique national spécifique concernant la mort fœtale n’existe à ce jour en France

[Fetuses born lifeless: new representations and new rights.]

International audienceA february-2008 rule about > stressed that > could be registered at the General Register Office. This rule, which was followed in 2009 by the implementation of new procedures to deal with dead fetuses, highlighted that this topic is more and more becoming an important public issue. The rights for parents to choose has now been recognized, bringing about new questions for health professionals. Another point is which symbolism is to be given to dead fetuses to alleviate couples' suffering, without being too ideological, i.e. seeing fetuses as persons. This change also makes professionals reconsider public health system priorities, and this at a very particular time. Indeed, as parent mourning has now been made easier through registration at the General Register Office, there has not been any rule yet linking national epidemiological registration and fetal death in France. double dagger

Long-term efficacy and safety of tension free vaginal tape in a historic cohort of 463 women with stress urinary incontinence

International audienceINTRODUCTION AND HYPOTHESIS:We report retrospective data on the long-term safety and efficacy of the retropubic midurethral sling (MUS) in a large series of women with stress urinary incontinence.METHODS:In all, 517 patients were treated during the period January 2005 to June 2012 at a single centre in France. The Urinary Symptoms Profile score was used to identify women who were subjectively cured or improved or in whom treatment had failed. The rates of peroperative, and early (<30 days) and late postoperative complications were recorded.RESULTS:A total of 463 patients were evaluable at a mean (±SD) follow-up of 71 ± 23 months. At the last follow-up, 344 patients (74.3 %) demonstrated subjective cure, 55 (11.9 %) were improved and 64 (13.8 %) had treatment failure. Bladder perforations occurred in 33 patients (7.1 %); however, this had no effect on cure rate. In the early postoperative period, temporary intermittent self-catheterization was required in 10 patients (2.2 %) due to voiding difficulties. The most frequent long-term postoperative complication was de novo urge incontinence that was reported by 59 patients (12.7 %); seven patients (1.5 %) needed tape excision due to voiding difficulties and six (1.3 %) needed tape removal due to erosion or chronic pain.CONCLUSIONS:The retropubic MUS was shown to be durable at a mean follow-up of 71 ± 23 months, with a high success/improvement rate and no serious long-term tape-induced adverse effects

[The irresponsible psychiatric patient, the new actor of the criminal procedure: the evolution of the notion of penal irresponsibility].

International audienc

Le patient psychiatrique irresponsable, nouvel acteur de la procédure pénale

Au cœur d’une société où les valeurs sont en mutation, le malade irresponsable, jusqu’alors écarté des procédures, se voit intégré dans le processus judiciaire pénal. Même si le Code pénal et le Code civil sont à ce jour inchangés, le Code de procédure pénale connaît un remaniement majeur. Le Code de santé publique pourrait également connaître une révision prochaine. Ainsi, si la loi du 25 février 2008 clôt une quinzaine d’années de réflexion et d’évolution autour de la notion de l’irresponsabilité pénale pour trouble psychique, elle ouvre parallèlement tout un champ de nouvelles pratiques. La présence du patient psychiatrique lors du procès pose une difficile question d’équilibre. Pour le malade d’abord, entre respect de ses particularités et de son statut de citoyen à part entière qui doit répondre de ses actes lorsque son état le permet. Pour les victimes ensuite : équilibre entre le respect de leur place nouvelle si durement acquise au coeur des procédures judiciaires et le sens fondamental de l’action judiciaire qui ne peut considérer que les intérêts individuels. Ces remaniements nous font nous interroger sur le rôle du médecin psychiatre auprès du malade et de la société

Advance directives and the family: French and American perspectives.

International audienceSeveral studies have explored differences between North American and European doctor-patient relationships. They have focused primarily on differences in philosophical traditions and historic and socio-economic factors between these two regions that might lead to differences in behaviour, as well as divergent concepts in and justifications of medical practice. However, few empirical intercultural studies have been carried out to identify in practice these cultural differences. This lack of standard comparative empirical studies led us to compare differences between France and the USA regarding end-of-life decision making. We tested certain assertions put forward by bioethicists concerning the impact of culture on the acceptance of advance directives in such decisions. In particular, we compared North American and French intensive care professional's attitudes toward: 1) advance directives and 2) the role of the family in decisions to withhold or withdraw life-support