Vers une herméneutique pluraliste du religieux dans les récits de superhéros : une approche orientée par la pensée de McLuhan

Le genre du super-héros s’impose de plus en plus dans l’imaginaire populaire. Les fictions de ce type suscitent l’intérêt des savants en raison de leur façon de véhiculer l’idéologie à travers des situations fantastiques. Les diverses manifestations du genre abordent implicitement ou explicitement des thèmes dont il est également question dans les discours religieux contemporains : autonomie et théonomie en éthique ; sacralité des hiérarchies, de l’environnement, des relations, de l’âme et du corps ; cosmogonie et eschatologie ; etc. Pour ne pas traiter à tort et à travers de l’enchevêtrement des univers religieux et fantastiques, il importe d’aborder cette convergence sous plusieurs angles susceptibles d’en faire ressortir les sens sans lui imposer de cohérence réductrice. Dans cet optique, une herméneutique pluraliste basée sur les perspectives interprétatives de Marshall et Eric McLuhan est tout indiquée. La méthode McLuhan propose trois angles d’approche, trois rapports d’altération entre culture de l’imaginaire et religieux contemporain : le super-héros critique, récupère et déconstruit les récits, discours et autres réalités du religieux. Puisque le temps et l’espace consacré à l’étude sont restreints par des considérations pratiques, son échantillon est limité aux « comic books » de super-héros des trente dernières années, à leurs produits dérivés et à la littérature savante qui s’y réfère

Acute bacterial prostatitis: heterogeneity in diagnostic criteria and management. Retrospective multicentric analysis of 371 patients diagnosed with acute prostatitis

<p>Abstract</p> <p>Background</p> <p>There is currently a lack of consensus for the diagnosis, investigations and treatments of acute bacterial prostatitis (AP).</p> <p>Methods</p> <p>The symptoms, investigations and treatments of 371 inpatients diagnosed with AP were analyzed through a retrospective study conducted in four departments – Urology (U), Infectious Diseases (ID), Internal Medicine (IM), Geriatrics (G) – of two French university hospitals.</p> <p>Results</p> <p>The cause of admission, symptoms, investigations and treatments depended markedly on the department of admission but not on the hospital. In U, patients commonly presented with a bladder outlet obstruction, they had a large imaging and functional check-up, and received alpha-blockers and anti-inflammatory drugs. In ID, patients were febrile and received longer and more appropriate antibiotic treatments. In G, patients presented with cognitive disorders and commonly had post-void urine volume measurements. In IM, patients presented with a wide range of symptoms, and had very diverse investigations and antibiotic regimen.</p> <p>Overall, a 3:1 ratio of community-acquired AP (CA-AP) to nosocomial AP (N-AP) was observed. Urine culture isolated mainly <it>E. coli </it>(58% of AP, 68% of CA-AP), with venereal agents constituting less than 1%. The probabilistic antibiotic treatments were similar for N-AP and CA-AP (58% bi-therapy; 63% fluoroquinolone-based regimen). For N-AP, these treatments were more likely to be inadequate (42% <it>vs. </it>8%, p < 0.001) and had a higher rate of bacteriological failure (48% <it>vs. </it>19%, p < 0.001).</p> <p>Clinical failure at follow-up was more common than bacteriological failure (75% versus 24%, p < 0.001). Patients older than 49 had more underlying urinary tract disorders and a higher rate of clinical failure (30% versus 10%, p < 0.0001).</p> <p>Conclusion</p> <p>This study highlights the difficulties encountered on a daily basis by the physicians regarding the diagnosis and management of acute prostatitis.</p

Le traitement médicaldes prolactinomes

Dans cet article, nous revoyons les grands principes du traitement médical moderne des prolactinomes par les agonistes dopaminergiques, l’efficacité de ces médicaments sur l’hypersécrétion hormonale et le volume tumoral ainsi que leurs effets secondaires principaux. Les questions d’actualité concernant l’interruption potentielle du traitement médical et les effets secondaires valvulaires cardiaques sont également discutées. Par contre, nous n’aborderons pas ici en détail le traitement des tumeurs agressives ou des carcinomes à prolactine (sujet abordé dans un autre article de la revue), ni le problème de la grossesse chez une femme traitée par agonistes dopaminergiques. Le lecteur intéressé par cette question est invité à se référer à une revue récente (M. Molitch, Best Pract Res Clin Endocrinol Metab 2011 ; 25 : 885

Infrasellar pituitary gangliocytoma causing Cushing's syndrome

INTRODUCTION: Pituitary gangliocytomas are uncommon neuronal tumours that may present with endocrine disorders, the most frequent being acromegaly caused by growth hormone hypersecretion. Cushing's syndrome is very rarely seen with gangliocytomas. MATERIAL AND METHODS: We report the unique case of a 62 year-old woman whose clinical picture and endocrine testing clearly demonstrated adrenocorticotropin (ACTH)-dependent Cushing's syndrome. Pituitary magnetic resonance imaging showed a 12-mm homogeneous, infra- and retrosellar mass first diagnosed as pituitary macroadenoma. Transsphenoidal surgery was performed and allowed complete resection of the tumour with sparing of normal anterior pituitary. Very low postoperative serum cortisol and ACTH levels were observed in the early postoperative period and the patient is still in remission 18 months after surgery, thus demonstrating that the resected lesion was entirely responsible for the clinical picture. RESULTS: Histological and immunocytochemical analyses demonstrated a benign tumour composed of mature neuronal cells suggestive of a gangliocytoma, expressing both ACTH and corticotropin-releasing hormone (CRH). The tumour was surrounded by a rim of pituitary tissue containing ACTH-producing endocrine cells. Careful analysis of the resected lesion did not reveal any pituitary microadenoma. We search literature for similar cases and retraced only nine cases of gangliocytomas associated with Cushing's syndrome. In most of them, the tumour was combined with either pituitary corticotroph adenoma or hyperplasia. CONCLUSIONS: Our case represents a unique case of an infrasellar pituitary gangliocytoma which was able to cause Cushing's syndrome by both direct ACTH production and CRH-induced stimulation of neighbour normal corticotroph cells

Proteins behaving badly. Substoichiometric molecular control and amplification of the initiation and nature of amyloid fibril formation: lessons from and for blood clotting1.

AbstractThe chief and largely terminal element of normal blood clotting is considered to involve the polymerisation of the mainly α-helical fibrinogen to fibrin, with a binding mechanism involving ‘knobs and holes’ but with otherwise little change in protein secondary structure. We recognise, however, that extremely unusual mutations or mechanical stressing can cause fibrinogen to adopt a conformation containing extensive β-sheets. Similarly, prions can change morphology from a largely α-helical to largely β-sheet conformation, and the latter catalyses both the transition and the self-organising polymerisation of the β-sheet structures. Many other proteins can also do this, where it is known as amyloidogenesis. When fibrin is formed in samples from patients harbouring different diseases it can have widely varying diameters and morphologies. We here develop the idea, and summarise the evidence, that in many cases the anomalous fibrin fibre formation seen in such diseases actually amounts to amyloidogenesis. In particular, fibrin can interact with the amyloid-β (Aβ) protein that is misfolded in Alzheimer's disease. Seeing these unusual fibrin morphologies as true amyloids explains a great deal about fibrin(ogen) biology that was previously opaque, and provides novel strategies for treating such coagulopathies. The literature on blood clotting can usefully both inform and be informed by that on prions and on the many other widely recognised (β-)amyloid proteins. A preprint has been lodged in bioRxiv (Kell and Pretorius, 2016)