The first crystal structure of the pyrrolo[1,2-c]oxazole ring system

The title compound, C7H4F3NO2, 3-tri­fluoro­methyl-1H-pyrrolo­[1,2-c]oxazol-1-one, is the first crystal structure of the pyrrolo­[1,2-c]oxazole ring system: the fused ring system is almost planar (r.m.s. deviation = 0.006 Å). In the crystal, weak C—H⋯O and C—H⋯F hydrogen bonds link the mol­ecules into [001] chains and π–π stacking inter­actions consolidate the structure

Phenomenological contribution to understanding of vocally disruptive behaviour: A clinical case study in a patient with dementia.

Behavioural and psychological symptoms of dementia (BPSD) cause great suffering in patients and their families. Phenomenology can help clarify the diagnosis and propose some new therapeutic responses using Daseinsanalyse. Separation issues understood using the phenomenological description of the melancholic type (MT) by Tellenbach may further shed light on our understanding of depression in dementia. In a 90-year-old woman presenting with advanced (Clinical Dementia Rating 3) mixed dementia and BPSD in the form of vocally disruptive behaviour (VDB), we discuss separation anxiety as the aetiopathogenic hypothesis. Depression and BPSD were assessed using the Neuropsychiatric Inventory, Cornell scale, and Montgomery-Åsberg Depression Rating Scale to confirm our second phenomenological diagnostic hypothesis, ie, melancholy. The Big Five Inventory scale filled in by a proxy was also used to evaluate the patient's premorbid personality. We then propose an explanatory frame of VDB and depression through the standard phenomenological assessment of its relation to time, space, self, and other. Confirming MT, we found an inhibited temperament and low openness to experience in the patient, as well as a symbiotic relationship with a close relative (the other). Separation anxiety may well explain the patient's MT expressed by VDB. Melancholic type and her symbiotic relationship led to a situation unbearable to the patient and her close relative unable to delegate care to a specialized team. Phenomenology in vocally disruptive behaviour in dementia. We have found new explanations in similar clinical cases in dementia as follows. A patient presenting with vocally disruptive behaviour has a melancholic type, a behavioural-inhibited temperament, and marital violence in the past. Phenomenology may help explain this profile with neurobiological disorders. The life trajectory, from childhood into older age, must be taken into account to understand behavioural and psychological symptoms of dementia

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

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L’auteure propose une réflexion sur la palilalie du sujet atteint de maladie d’Alzheimer à un stade sévère. Si, la plupart du temps, ce comportement de répétition verbale est considéré comme insensé, l’objectif est d’en apporter une nouvelle approche, avec notamment l’hypothèse d’une involution du système de représentation du sujet démentDans la palilalie, ce n’est plus tant le contenu qui compte mais la manière de dire. Ainsi, en mettant l’accent sur le dire plutôt que sur le dit ainsi que sur les manifestations du corps, l’auteure en arrive à la conclusion que la prosodie de la palilalie devient un indicateur important concernant l’état d’angoisse du sujet dément. Dès lors, l’environnement dans lequel se trouve le sujet dément est primordial. Plus l’angoisse augmente et plus le débit de la palilalie sera rapide et la tonalité élevée.Après avoir tenté de « répéter la répétition » avec le sujet dément, et avoir constaté que cette méthode faisait naître de nouvelles syllabes, l’auteure a proposé une thérapie par la musique aux trois sujets de cette recherche, dans l’espoir que la médiation musicale pérennise les effets bénéfiques initialement constatés. Les résultats ont permis de valider l’hypothèse selon laquelle la musique active et/ou passive a un effet positif sur la palilalie, à la fois en termes d’apaisement et de relance symbolique.In fne, cette étude suggère plus largement que la palilalie n’a pas (seulement) une cause neurologique comme les recherches le suggéraient jusqu’à maintenant, puisque la modulation de l’environnement et la présence d’un autre bienveillant et à l’écoute sont capables de la canaliser.The author proposes a reflection on the palilalia of the subject suffering from Alzheimer's disease at a severe stage. If, most of the time, this behavior of verbal repetition is considered senseless, the aim is to bring a new approach, including the hypothesis of an involution of the system of representation of the subject denies.In palilalia, it is not so much the content that matters but the way of saying. Thus, by emphasizing the saying rather than the saying as well as on the manifestations of the body, the author concludes that the prosody of palilalia becomes an important indicator concerning the state of distress of the subject. From then on, the environment in which the Alzheimer subject is located is paramount. The more the distress increases, the more the flow of the palilalia will be fast and the tone high.After trying to "repeat the repetition" with Alzheimer subject, and finding that this method generated new syllables, the author proposed a music therapy to the three subjects of this research, in the hope that the mediation through music preserves the beneficial effects initially observed. The results validated the hypothesis that active and / or passive music has a positive effect on palilalia, both in terms of appeasement and symbolic relaunch.In fact, this study more broadly suggests that palilalia does not (only) have a neurological cause as research so far suggested, since the modulation of the environment and the presence of another benevolent and listen are able to channel it

Mélodie d'Alzheimer et palilalie : les enjeux du dévoilement des processus archaïques dans la maladie Alzheimer à un stade avancé

The author proposes a reflection on the palilalia of the subject suffering from Alzheimer's disease at a severe stage. If, most of the time, this behavior of verbal repetition is considered senseless, the aim is to bring a new approach, including the hypothesis of an involution of the system of representation of the subject denies.In palilalia, it is not so much the content that matters but the way of saying. Thus, by emphasizing the saying rather than the saying as well as on the manifestations of the body, the author concludes that the prosody of palilalia becomes an important indicator concerning the state of distress of the subject. From then on, the environment in which the Alzheimer subject is located is paramount. The more the distress increases, the more the flow of the palilalia will be fast and the tone high.After trying to "repeat the repetition" with Alzheimer subject, and finding that this method generated new syllables, the author proposed a music therapy to the three subjects of this research, in the hope that the mediation through music preserves the beneficial effects initially observed. The results validated the hypothesis that active and / or passive music has a positive effect on palilalia, both in terms of appeasement and symbolic relaunch.In fact, this study more broadly suggests that palilalia does not (only) have a neurological cause as research so far suggested, since the modulation of the environment and the presence of another benevolent and listen are able to channel it.L’auteure propose une réflexion sur la palilalie du sujet atteint de maladie d’Alzheimer à un stade sévère. Si, la plupart du temps, ce comportement de répétition verbale est considéré comme insensé, l’objectif est d’en apporter une nouvelle approche, avec notamment l’hypothèse d’une involution du système de représentation du sujet démentDans la palilalie, ce n’est plus tant le contenu qui compte mais la manière de dire. Ainsi, en mettant l’accent sur le dire plutôt que sur le dit ainsi que sur les manifestations du corps, l’auteure en arrive à la conclusion que la prosodie de la palilalie devient un indicateur important concernant l’état d’angoisse du sujet dément. Dès lors, l’environnement dans lequel se trouve le sujet dément est primordial. Plus l’angoisse augmente et plus le débit de la palilalie sera rapide et la tonalité élevée.Après avoir tenté de « répéter la répétition » avec le sujet dément, et avoir constaté que cette méthode faisait naître de nouvelles syllabes, l’auteure a proposé une thérapie par la musique aux trois sujets de cette recherche, dans l’espoir que la médiation musicale pérennise les effets bénéfiques initialement constatés. Les résultats ont permis de valider l’hypothèse selon laquelle la musique active et/ou passive a un effet positif sur la palilalie, à la fois en termes d’apaisement et de relance symbolique.In fne, cette étude suggère plus largement que la palilalie n’a pas (seulement) une cause neurologique comme les recherches le suggéraient jusqu’à maintenant, puisque la modulation de l’environnement et la présence d’un autre bienveillant et à l’écoute sont capables de la canaliser