La schizophrénie touche aussi les enfants et les adolescents : une des modalités de leur prise en charge est assurée par le CTJA [Centre thérapeutique de jour pour adolescents]

1% des schizophrénies se déclenchent avant l'âge de 10 ans. 20%, une sur cinq, commencent avant l'âge de 18 ans. Et dans 40% des cas de schizophrénie avérée, les premiers signes étaient apparus avant 18 ans. En septembre 2003, CHUV-Magazine a fait le tour de la prise en charge des schizophrènes adultes. L'entretien avec le Dr Laurent Holzer, médecin associéau Centre thérapeutique de jour pour adolescents (CTJA), complète ce dossier en abordant le problème de la schizophrénie chez les jeunes. [Réd.]]]> Schizophrenia ; Child ; Adolescent fre oai:serval.unil.ch:BIB_2EC91B403AE6 2022-05-07T01:14:06Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_2EC91B403AE6 Envelope glycoprotein of arenaviruses. info:doi:10.3390/v4102162 info:eu-repo/semantics/altIdentifier/doi/10.3390/v4102162 info:eu-repo/semantics/altIdentifier/pmid/23202458 Burri, D.J. Palma, J.R. Kunz, S. Pasquato, A. info:eu-repo/semantics/review article 2012 Viruses, vol. 4, no. 10, pp. 2162-2181 info:eu-repo/semantics/altIdentifier/eissn/1999-4915 urn:issn:1999-4915 <![CDATA[Arenaviruses include lethal human pathogens which pose serious public health threats. So far, no FDA approved vaccines are available against arenavirus infections, and therapeutic options are limited, making the identification of novel drug targets for the development of efficacious therapeutics an urgent need. Arenaviruses are comprised of two RNA genome segments and four proteins, the polymerase L, the envelope glycoprotein GP, the matrix protein Z, and the nucleoprotein NP. A crucial step in the arenavirus life-cycle is the biosynthesis and maturation of the GP precursor (GPC) by cellular signal peptidases and the cellular enzyme Subtilisin Kexin Isozyme-1 (SKI-1)/Site-1 Protease (S1P) yielding a tripartite mature GP complex formed by GP1/GP2 and a stable signal peptide (SSP). GPC cleavage by SKI-1/S1P is crucial for fusion competence and incorporation of mature GP into nascent budding virion particles. In a first part of our review, we cover basic aspects and newer developments in the biosynthesis of arenavirus GP and its molecular interaction with SKI-1/S1P. A second part will then highlight the potential of SKI-1/S1P-mediated processing of arenavirus GPC as a novel target for therapeutic intervention to combat human pathogenic arenaviruses

Foreign ant queens are accepted but produce fewer offspring

Understanding social evolution requires us to understand the processes regulating the number of breeders within social groups and how they partition reproduction. Queens in polygynous (multiple queens per colony) ants often seek adoption in established colonies instead of founding a new colony independently. This mode of dispersal leads to potential conflicts, as kin selection theory predicts that resident workers should favour nestmate queens over foreign queens. Here we compared the survival of foreign and resident queens as well as their relative reproductive share. We used the ant Formica exsecta to construct colonies consisting of one queen with workers related to this resident queen and introduced a foreign queen. We found that the survival of foreign queens did not differ from that of resident queens over a period of 136days. However, the genetic analyses revealed that resident queens produced a 1.5-fold higher number of offspring than introduced queens, and had an equal or higher share in 80% of the colonies. These data indicate that some discrimination can occur against dispersing individuals and that dispersal can thus have costs in terms of direct reproduction for dispersing queen

Genetic clusters and sex-biased gene flow in a unicolonial Formica ant

BACKGROUND: Animal societies are diverse, ranging from small family-based groups to extraordinarily large social networks in which many unrelated individuals interact. At the extreme of this continuum, some ant species form unicolonial populations in which workers and queens can move among multiple interconnected nests without eliciting aggression. Although unicoloniality has been mostly studied in invasive ants, it also occurs in some native non-invasive species. Unicoloniality is commonly associated with very high queen number, which may result in levels of relatedness among nestmates being so low as to raise the question of the maintenance of altruism by kin selection in such systems. However, the actual relatedness among cooperating individuals critically depends on effective dispersal and the ensuing pattern of genetic structuring. In order to better understand the evolution of unicoloniality in native non-invasive ants, we investigated the fine-scale population genetic structure and gene flow in three unicolonial populations of the wood ant F. paralugubris. RESULTS: The analysis of geo-referenced microsatellite genotypes and mitochondrial haplotypes revealed the presence of cryptic clusters of genetically-differentiated nests in the three populations of F. paralugubris. Because of this spatial genetic heterogeneity, members of the same clusters were moderately but significantly related. The comparison of nuclear (microsatellite) and mitochondrial differentiation indicated that effective gene flow was male-biased in all populations. CONCLUSION: The three unicolonial populations exhibited male-biased and mostly local gene flow. The high number of queens per nest, exchanges among neighbouring nests and restricted long-distance gene flow resulted in large clusters of genetically similar nests. The positive relatedness among clustermates suggests that kin selection may still contribute to the maintenance of altruism in unicolonial populations if competition occurs among clusters

Computer-assisted cognitive remediation in adolescents with psychosis or at risk for psychosis: a 6-month follow-up

Urben S, Pihet S, Jaugey L, Halfon O, Holzer L. Computer-assisted cognitive remediation in adolescents with psychosis or at risk for psychosis: a 6-month follow-up. Objective: To investigate short-term outcomes of a computer-assisted cognitive remediation (CACR) for adolescents with psychotic disorders or at high risk for psychosis. Method: Cognitive abilities and clinical status were assessed at baseline (N = 32) and at 6-month follow-up (N = 22) after enrolment in either a CACR (treatment group) or a computer games (control group) program (8 weeks). Results: With regard to the cognitive abilities, no amelioration was found in the control group while, in the CACR group, significant improvements in inhibition (p = 0.040) and reasoning (p = 0.005) were observed. Furthermore, symptom severity decreased significantly in the control group (p = 0.046) and marginally in the CACR group (p = 0.088). Improvements in cognitive abilities were not associated with symptoms' amelioration. Finally, increase in reasoning abilities was related to the median effective work time in sessions of CACR (R = 0.64, p = 0.024). Conclusion: At follow-up, enhanced cognitive abilities (reasoning and inhibition), which are necessary for executing higher-order goals or adapting behaviour to the ever-changing environment, were reported in adolescents participants of the CACR. Thus, further studies are needed to confirm and extend these interesting result

Community Introduction of Practice Parameters for Autistic Spectrum Disorders: Advancing Early Recognition

Objectives: Within a strong interdisciplinary framework, improvement in the quality of care for children with autistic spectrum disorders through a 2year implementation program of Practice Parameters, aimed principally at improving early detection and intervention. Method: We developed Practice Parameters (PPs) for Pervasive Developmental Disorders and circulated the PPs to all child and adolescent psychiatrists practicing in the region. Results: PP development and parallel information strategies resulted in a significant decrease of 1.5years in the mean-age-at-diagnosis. However, further analysis indicated that improvement was only transient. Conclusion: Despite the encouraging improvement in mean-age-at-diagnosis 2years after PP implementation, other indicators showed a failure to maintain the improvements. A systematic screening program would be the most reliable method to reinforce the PP

Cognitive Efficacy of Quetiapine in Early-Onset First-Episode Psychosis: A 12-Week Open Label Trial

Twenty-three adolescents with psychotic disorders, aged from 13 to 18years, participated in a 12-week open label trial (17 adolescents completed the study) in order to examine the impact of quetiapine on clinical status and cognitive functions (encompassing processing speed, attention, short-term memory, long-term memory and executive function). An improvement in Clinical Global Impression and Positive and Negative Symptom Scale (P's≤0.001) was observed. In addition, after controlling for amelioration of symptoms, a significant improvement was observed on one executive function (P=0.044; Trail Making Part B). The remaining cognitive abilities showed stability. In addition, we observed an interaction between quetiapine doses (>300mg/day or <300mg/day) and time, where lower doses showed more improvement in verbal short-term memory (P=0.048), inhibition abilities (P=0.038) and positive symptoms (P=0.020). The neuropsychological functioning of adolescents with psychotic disorders remained mainly stable after 12weeks of treatment with quetiapine. However, lower doses seemed to have a better impact on two components of cognition (inhibition abilities and verbal short-term memory) and on positive symptom

A Randomized Controlled Trial of the Effectiveness of Computer-Assisted Cognitive Remediation (CACR) in Adolescents with Psychosis or at High Risk of Psychosis

Background: Computer assisted cognitive remediation (CACR) was demonstrated to be efficient in improving cognitive deficits in adults with psychosis. However, scarce studies explored the outcome of CACR in adolescents with psychosis or at high risk. Aims: To investigate the effectiveness of a computer-assisted cognitive remediation (CACR) program in adolescents with psychosis or at high risk. Method: Intention to treat analyses included 32 adolescents who participated in a blinded 8-week randomized controlled trial of CACR treatment compared to computer games (CG). Cognitive abilities, symptoms and psychosocial functioning were assessed at baseline and posttreatment. Results: Improvement in visuospatial abilities was significantly greater in the CACR group than in CG. Other cognitive functions, psychotic symptoms and psychosocial functioning improved significantly, but at similar rates, in the two groups. Conclusion: CACR can be successfully administered in this population; it proved to be effective over and above CG for the most intensively trained cognitive abilit

Phlegmonous colitis: another source of sepsis in cirrhotic patients?

<p>Abstract</p> <p>Background</p> <p>The clinical relevance of phlegmonous colitis (PC), a rare autopsy finding in cirrhotic patients, is poorly documented. We postulated that PC might be a source of sepsis in patients with portal hypertensive colopathy (PHC).</p> <p>Case presentation</p> <p>We report three cirrhotic patients who were admitted with abdominal sepsis and who illustrate, to various degrees, the clinico-pathological sequence of colonic alterations associated with portal hypertension. Two cirrhotic patients with PHC developed gram-negative bacteraemia and quickly responded to intravenous antibiotics. Another cirrhotic patient underwent emergency colectomy for PC, and subsequently died from multiple organ failure. Histological alterations in the operative specimen included: a) mucosal ulcerations; b) disseminated micro-abscesses in the submucosa; and c) a severe vasculopathy leading to complete obliteration of submucosal blood vessels.</p> <p>Conclusions</p> <p>These data suggest that cirrhotic patients with PHC may progress towards PC, which, in turn, may be the cause for life-threatening sepsis.</p

Fragebogen zur Behandlungszufriedenheit in der stationären Kinder- und Jugendpsychiatrie (FBZ-KJP) - Ergebnisse einer Schweizer Pilotstudie

Fragestellung: Die Patientenzufriedenheit ist ein etablierter Qualitätsindikator für medizinische Interventionen, welchen die Kostenträger im Gesundheitssystem zunehmend als Indikator heranziehen, um Unterschiede zwischen Kliniken sichtbar zu machen. Die Erfassung der Patientenzufriedenheit stellt die Kinder- und Jugendpsychiatrie/-psychotherapie (KJPP) vor besondere Herausforderungen (Entwicklungsstand, Rolle der Eltern). Die bestehenden Patientenzufriedenheitsinstrumente erwiesen sich als zu unspezifisch, um die verschiedenen Aspekte einer stationären KJPP-Behandlung abbilden zu können. Deshalb setzte sich eine Arbeitsgruppe im Auftrag der Schweizerischen Gesellschaft für Kinder und Jugendpsychiatrie (SGKJPP) zum Ziel, ein psychometrisches Instrument für die Patienten- und Elternzufriedenheit zu entwickeln, welches in den deutsch- und französischsprachigen Sprachregionen eingesetzt werden kann. Methodik: Die erste Anwendung und Überprüfung dieses Fragebogens in einer multizentrischen Pilotstudie mit einer Stichprobe von 174 Patientinnen und Patienten und 145 Eltern aus sechs Kliniken wird in diesem Artikel vorgestellt. Ergebnisse: Die Ergebnisse zeigen hervorragende Testgütekriterien des Instrumentariums (Cronbachs α = .93 bzw. α = .97 (Eltern-/Patientenversion). Die Fragebogenvarianten besitzen eine hohe konvergente Validität; die Korrelation zum Client Satisfaction Questionnaire (CSQ-8) beträgt p = .80 bzw. .83 (Patienten-, Elternurteil). Zudem differenzieren sie zwischen den einzelnen Kliniken. Die Korrelationen zwischen Patienten- und Elternurteil liegen bei moderaten p = .29 für den Gesamttest-Score und p = .39 für den CSQ-8. Schlussfolgerungen: Der Fragebogen eignet sich für die Beschreibung der Qualitätsentwicklung in der KJPP und kann als Standardverfahren für die Erfassung der Patientenzufriedenheit empfohlen werden. = Objectives: Patient satisfaction is an established indicator for medical interventions. Existing questionnaires for the assessment of patient satisfaction in child and adolescent psychiatry are too global to target quality improvement in child and adolescent psychiatric hospitals. The assessment of patient satisfaction in child and adolescent psychiatry is very challenging because specific demands (development status, role of parents in treatment) have been taken into account. Therefore, an expert team leaded by the Swiss Society of Child and Adolescent Psychiatry developed a targeted instrument to assess patient satisfaction in both language regions (i. e., German and French). Methods: The article reviews the development of a new child and adolescent psychiatric questionnaire for the assessment of patient satisfaction as well as the findings of a survey conducted in a representative sample of 174 patients and 145 parents in six hospitals. Results: The internal consistency (Cronbach’s α = .93) is excellent. The questionnaire has high levels of both convergence and face validity, and the correlation with the Client Satisfaction Questionnaire (CSQ-8) is ρ = .80 (patient-report) and .83 (parent-report). Furthermore, this questionnaire reveals the relative strengths and weaknesses of individual hospitals. The correlation between patient and parent assessment is, as expected, moderate (ρ = .29, for the total score and ρ = .39 for the CSQ-8). Conclusions: The Patient Satisfaction Questionnaire can be recommended to professionals as a standard for collecting data on client satisfaction within child and adolescent psychiatry