19 research outputs found

    La fin de la condition féminine ?

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    « Le colloque Comprendre la Ve République nous apparaßt comme lune des trop rares manifestations scientifiques organisées pour commémorer la naissance dun régime politique aujourdhui quasiment accepté par tous. La comparaison avec la déferlante du 40e anniversaire de Mai 68 pose demblée la question du tri mémoriel, mais nous renvoie aussi à des problématiques spécifiques de lhistorien. () Le décalage entre la logique mémorielle et la volonté critique du chercheur est à la source de ce colloque. De notre point de vue dhistorien, il sagit de privilégier des questionnements sur le long terme, la confrontation entre lévolution dun régime politique et les grandes évolutions de la société française, dans tous les champs possibles, sociaux, économiques, culturels, médiatiques, religieux, internationaux. Si la chronologie politique jalonne évidemment notre réflexion, marquée par des étapes décisives comme la présidentialisation de 1962, la crise de Mai 68, lalternance de 1981 ou la cohabitation de 1986, notre démarche est celle de la synthÚse thématique, visant à éviter les perspectives mémorielles ou journalistiques. Cest la raison pour laquelle nous avons demandé aux contributeurs, quils soient historiens, politistes ou sociologues, dadopter un point de vue diachronique qui surplombe le demi-siÚcle, ce qui navait jamais été tenté jusque là, et pour cause. » (Extrait de l\u27Introduction de J. Garrigues et S. Guillaume.

    Natalizumab treatment shows low cumulative probabilities of confirmed disability worsening to EDSS milestones in the long-term setting.

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    Abstract Background Though the Expanded Disability Status Scale (EDSS) is commonly used to assess disability level in relapsing-remitting multiple sclerosis (RRMS), the criteria defining disability progression are used for patients with a wide range of baseline levels of disability in relatively short-term trials. As a result, not all EDSS changes carry the same weight in terms of future disability, and treatment benefits such as decreased risk of reaching particular disability milestones may not be reliably captured. The objectives of this analysis are to assess the probability of confirmed disability worsening to specific EDSS milestones (i.e., EDSS scores ≄3.0, ≄4.0, or ≄6.0) at 288 weeks in the Tysabri Observational Program (TOP) and to examine the impact of relapses occurring during natalizumab therapy in TOP patients who had received natalizumab for ≄24 months. Methods TOP is an ongoing, open-label, observational, prospective study of patients with RRMS in clinical practice. Enrolled patients were naive to natalizumab at treatment initiation or had received ≀3 doses at the time of enrollment. Intravenous natalizumab (300 mg) infusions were given every 4 weeks, and the EDSS was assessed at baseline and every 24 weeks during treatment. Results Of the 4161 patients enrolled in TOP with follow-up of at least 24 months, 3253 patients with available baseline EDSS scores had continued natalizumab treatment and 908 had discontinued (5.4% due to a reported lack of efficacy and 16.4% for other reasons) at the 24-month time point. Those who discontinued due to lack of efficacy had higher baseline EDSS scores (median 4.5 vs. 3.5), higher on-treatment relapse rates (0.82 vs. 0.23), and higher cumulative probabilities of EDSS worsening (16% vs. 9%) at 24 months than those completing therapy. Among 24-month completers, after approximately 5.5 years of natalizumab treatment, the cumulative probabilities of confirmed EDSS worsening by 1.0 and 2.0 points were 18.5% and 7.9%, respectively (24-week confirmation), and 13.5% and 5.3%, respectively (48-week confirmation). The risks of 24- and 48-week confirmed EDSS worsening were significantly higher in patients with on-treatment relapses than in those without relapses. An analysis of time to specific EDSS milestones showed that the probabilities of 48-week confirmed transition from EDSS scores of 0.0–2.0 to ≄3.0, 2.0–3.0 to ≄4.0, and 4.0–5.0 to ≄6.0 at week 288 in TOP were 11.1%, 11.8%, and 9.5%, respectively, with lower probabilities observed among patients without on-treatment relapses (8.1%, 8.4%, and 5.7%, respectively). Conclusions In TOP patients with a median (range) baseline EDSS score of 3.5 (0.0–9.5) who completed 24 months of natalizumab treatment, the rate of 48-week confirmed disability worsening events was below 15%; after approximately 5.5 years of natalizumab treatment, 86.5% and 94.7% of patients did not have EDSS score increases of ≄1.0 or ≄2.0 points, respectively. The presence of relapses was associated with higher rates of overall disability worsening. These results were confirmed by assessing transition to EDSS milestones. Lower rates of overall 48-week confirmed EDSS worsening and of transitioning from EDSS score 4.0–5.0 to ≄6.0 in the absence of relapses suggest that relapses remain a significant driver of disability worsening and that on-treatment relapses in natalizumab-treated patients are of prognostic importance

    Traitement chirurgical de la maladie de Parkinson par stimulation bilatérale des glubus pallidums internes (suivi prospectif de huit patients)

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    MONTPELLIER-BU MĂ©decine UPM (341722108) / SudocPARIS-BIUM (751062103) / SudocMONTPELLIER-BU MĂ©decine (341722104) / SudocSudocFranceF

    Comprendre la Ve RĂ©publique

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    Le projet de ce livre se dĂ©finit Ă  la fois par un amont et par un aval : en amont, le bilan des connaissances dĂ©jĂ  accumulĂ©es par les historiens sur cinquante ans d'histoire quinto-rĂ©publicaine : en avol, une rĂ©flexion Ă  mener sur les approches Ă  mettre en oeuvre pour enrirchir davantage l'apport des historiens Ă  la connaissance de ces dĂ©cennies d'histoire proche, partagĂ©es en copropriĂ©tĂ© intellectuelle avec d'autres sciences sociales.Atant qu'un bilan, le colloque ayant donnĂ© le jour Ă  cet ouvrage se voulait, en effet, un laboratoire expĂ©rimental : comment progresser, aussi bien dans la connaissance historique de ce demi-siĂšcle d'histoire nationale que dans les mĂ©thodes dĂ©ployĂ©es, pour proposer une dĂ©marche stabilisĂ©e scientifiquement, tant est toujours complexe la mise en oeuvre d'une histoire du temps prĂ©sent, domaine pleinement lĂ©gitime mais difficile Ă  arpenter par l'historien ? En mĂȘme temps, il est vrai que la mise en perspective multi-dĂ©cennale de sujets trĂšs proches confĂšre aux historiens une place non nĂ©gligeable.S'il en Ă©tait encore besoin, ce livre tĂ©moigne donc tout Ă  la fois de la vigueur intellectuelle et scientifique d'une histoire politique renouvelĂ©e et de la fĂ©conditĂ© des dĂ©marches dites d'histoire du temps prĂ©sent

    Histoire de l'UDF

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    FondĂ©e le 1er fĂ©vrier 1978, l'Union pour la dĂ©mocratie française a Ă©tĂ© pendant trente ans l'un des grands partis politiques français. Bien que la crĂ©ation de l'UMP en 2002 puis celle du MoDem en 2007 aient finalement scellĂ© son sort, l'UDF a jouĂ© un rĂŽle de tout premier plan dans la vie politique nationale. StructurĂ©e de façon originale par rapport Ă  ses concurrents, elle rassembla quelques-unes des plus anciennes familles politiques (libĂ©raux, radicaux, dĂ©mocrates-chrĂ©tiens), ce qui fit sa complexitĂ©. Par ses Ă©lus, l'UDF a dirigĂ© des milliers de communes, des dizaines de dĂ©partements et de rĂ©gions. Elle a participĂ© pendant prĂšs de 20 ans au gouvernement de la France. À travers son fondateur, elle a mĂȘme contrĂŽlĂ© la prĂ©sidence de la RĂ©publique de 1978 Ă  1981. Aucune histoire globale de l'UDF n'existait encore Ă  ce jour. Les chercheurs et les acteurs-tĂ©moins de ce livre, issu d'un colloque tenu en novembre 2011, ont voulu combler cette lacune

    Agriculture, sylviculture et gaz Ă  effet de serre : observations du rĂ©seau EcosystĂšmes-Fr de l’infrastructure ICOS

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    Agriculture, sylviculture et gaz Ă  effet de serre : observations du rĂ©seau EcosystĂšmes-Fr de l’infrastructure ICOS. Carbones atmosphĂ©riques naturels et anthropiques. Chaire Évolution du climat et de l'ocĂ©an du CollĂšge de Franc

    Characteristics and outcomes of intensive care unit patients with respiratory syncytial virus compared to those with influenza infection: a multicentre matched cohort study.

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    The characteristics and outcomes of adult patients with respiratory syncytial virus (RSV) infection who require intensive care unit (ICU) admission are poorly defined. Although several studies in adults with RSV infection have been published in recent years, they did not focus specifically on critically ill patients. What are the characteristics and outcomes of adult ICU patients with RSV infection, and how do they compare to those of ICU patients with influenza infection? This retrospective, multicentre study in France and Belgium (17 sites) compared the characteristics and outcomes of adult ICU patients with RSV infection versus influenza infection between November 2011 and April 2018. Each patient with RSV infection was matched by institution and date of diagnosis with a patient with influenza infection. In-hospital mortality was compared between the two groups, with adjustment for prognostic factors in a multivariable model (sex, age, main underlying conditions, and concurrent bloodstream infection). Data from 618 patients (309 with RSV infection and 309 with influenza infection) were analysed. Patients with RSV infection were significantly more likely to have an underlying chronic respiratory condition (60.2% versus 40.1%, p<0.001) and to be immunocompromised (35% versus 26.2%, p=0.02) than patients with influenza infection. There were several differences in clinical signs and biological data at diagnosis between the groups. In-hospital mortality was not significantly different in the two groups (23.9% in the RSV group versus 25.6% in the influenza group, p=0.63), even after adjustment for prognostic factors in a multivariable model. Adult ICU patients with RSV infection differ from adult ICU patients with influenza in terms of comorbidities and characteristics at diagnosis. RSV infection was associated with high in-hospital mortality, approaching 25%. In multivariable analysis, RSV infection was associated with a similar odds of in-hospital death compared to influenza infection

    DĂ©noncer la corruption

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    La vie politique de nombreux pays est marquĂ©e, depuis les annĂ©es 1980, par la rĂ©currence des scandales de corruption et des affaires politicofinanciĂšres, et la dĂ©nonciation des manquements Ă  la morale civique, des pratiques de favoritisme et des conflits d'intĂ©rĂȘts est devenue une question centrale dans nos dĂ©mocraties. Elle soulĂšve de multiples dĂ©bats, sur le rĂŽle des dĂ©nonciateurs ou des « fuites », sur le droit Ă  l'information, sur les valeurs publiques associĂ©es Ă  la transparence. Le recours Ă  l'histoire, clĂ© de l'intelligence du prĂ©sent, s'impose ici, en lien avec une analyse sociologique des acteurs — trĂšs divers : qui sont ces chevaliers blancs de la morale et ces promoteurs de la transparence des xixe et xxe siĂšcles ? De quels vocabulaires et registres usent-ils ? Quels sont les profils sociaux et pratiques prioritairement visĂ©s ? Quels sont les contextes les plus favorables Ă  l'essor des dĂ©nonciations ? Le prĂ©sent ouvrage rĂ©unit des contributions d'historiens, de politistes et de sociologues venus de neuf pays. Ces contributions offrent, Ă  travers un riche Ă©ventail d'Ă©tudes de cas rĂ©vĂ©lateurs, passĂ©s et contemporains, une vision contrastĂ©e de la dĂ©nonciation, Ă  la fois fruit de transformations de longue durĂ©e et tĂ©moin de l'entrĂ©e rĂ©cente dans une Ăšre marquĂ©e par des formes inĂ©dites de dĂ©fiance Ă  l'Ă©gard du pouvoir

    La recomposition des droites

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    1945 : « annĂ©e zĂ©ro » pour la droite en France ? C'est, encore aujourd'hui, l'idĂ©e qui domine bien souvent. Une droite vichyste discrĂ©ditĂ©e, sans chef, sans programme, sans organisation. Mais comment interprĂ©ter l'impressionnant succĂšs du tout jeune MRP en 1945-1946 ? Comment qualifier De Gaulle et la percĂ©e spectaculaire du RPF en 1947 ? Comment comprendre l'arrivĂ©e de Pinay Ă  Matignon en 1952, homme de la droite libĂ©rale, Ă©lu dĂ©putĂ© en 1936 contre le Front populaire puis membre du Conseil national de Vichy ? À tout cela, cet ouvrage collectif – issu d'un colloque tenu Ă  Rennes en mai 2003 – tente d'apporter des rĂ©ponses neuves. Il en ressort que la droite, plurielle, Ă©tait, dĂšs avant la DĂ©bĂącle, engagĂ©e dans un vaste processus de recomposition que la guerre puis la LibĂ©ration n'ont fait qu'Ă  la fois rĂ©orienter et prĂ©cipiter..

    Mutations in SPG11 are frequent in autosomal recessive spastic paraplegia with thin corpus callosum, cognitive decline and lower motor neuron degeneration.

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    Hereditary spastic paraplegias (HSP) are neurodegenerative diseases mainly characterized by lower limb spasticity associated, in complicated forms, with additional neurological signs. We have analysed a large series of index patients (n = 76) with this condition, either from families with an autosomal recessive inheritance (n = 43) or isolated patients (n = 33), for mutations in the recently identified SPG11 gene. We found 22 truncating mutations, including the first four splice-site mutations, segregating in seven isolated cases and 13 families. Nineteen mutations were novel. Two recurrent mutations were found in Portuguese and North-African patients indicating founder effects in these populations. The mutation frequency varied according to the phenotype, from 41%, in HSP patients presenting with a thin corpus callosum (TCC) visualized by MRI, to 4.5%, in patients with mental impairment without a TCC. Disease onset occurred during the first to the third decade mainly by problems with gait and/or mental retardation. After a mean disease duration of 14.9 +/- 6.6 years, the phenotype of 38 SPG11 patients was severe with 53% of patients wheelchair bound or bedridden. In addition to mental retardation, 80% of the patients showed cognitive decline with executive dysfunction. Interestingly, the phenotype also frequently included lower motor neuron degeneration (81%) with wasting (53%). Slight ocular cerebellar signs were also noted in patients with long disease durations. In addition to a TCC (95%), brain MRI revealed white matter alterations (69%) and cortical atrophy (81%), which worsened with disease duration. In conclusion, our study reveals the high frequency of SPG11 mutations in patients with HSP, a TCC and cognitive impairment, including in isolated patients, and extends the associated phenotype
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