Violences juvéniles sous expertise(s), XIXe-XXIe siècles

Résumé issu du site de l\u27éditeur : Dans la construction historique du problème social que constitue la violence juvénile, le rôle de l\u27expertise est primordial. L\u27expert, agissant au coeur ou à la lisière du système institutionnel de protection de la jeunesse, peut être celui qui recueille et met en forme l’expression de cette violence. De ce fait, il contribue à l’extension de sa définition : violence physique, mais aussi psychique, voire symbolique. Les experts dépassent alors la posture du simple diagnostic pour s’inscrire dans une démarche de soin et de réhabilitation sociale. Depuis le XIXe siècle, médecins, psychiatres, puis psychologues,  pédagogues, sociologues et anthropologues, ont investi la question de la jeunesse  irrégulière, contribuant ainsi à la définition d’une population-cible pour les politiques publiques

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Differential cellular gene expression in duck trachea infected with a highly or low pathogenic H5N1 avian influenza viru

The relationship between CD4+CD25+CD127- regulatory T cells and inflammatory response and outcome during shock states

International audienceINTRODUCTION: Although regulatory T lymphocytes (Tregs) have a pivotal role in preventing autoimmune diseases and limiting chronic inflammatory conditions, they may also block beneficial immune responses by preventing sterilizing immunity to certain pathogens. METHODS: To determine whether naturally occurring Treg cells have a role in inflammatory response and outcome during shock state we conducted an observational study in two adult ICUs from a university hospital. Within 12 hours of admission, peripheral whole blood was collected for the measurement of cytokines and determination of lymphocyte count. Sampling was repeated at day three, five and seven. Furthermore, an experimental septic shock was induced in adult Balb/c mice through caecal ligation and puncture. RESULTS: Forty-three patients suffering from shock (26 septic, 17 non septic), and 7 healthy volunteers were included. The percentage of Tregs increased as early as 3 days after the onset of shock, while their absolute number remained lower than in healthy volunteers. A similar pattern of Tregs kinetics was found in infected and non infected patients. Though there was an inverse correlation between severity scores and Tregs percentage, the time course of Tregs was similar between survivors and non survivors. No relation between Tregs and cytokine concentration was found. In septic mice, although there was a rapid increase in Treg cells subset among splenocytes, antibody-induced depletion of Tregs before the onset of sepsis did not alter survival. CONCLUSIONS: These data argue against a determinant role of Tregs in inflammatory response and outcome during shock states

Acétonide de triamcinolone en injection intravitréenne (effets sur l'oedème maculaire diabétique)

L œdème maculaire (OM) est la principale cause de malvoyance chez les patients diabétiques. Son traitement repose sur l équilibre de la glycémie, de la tension artérielle, et sur la photocoagulation maculaire par laser. Depuis 2001, l Acétonide de Triamcinolone (AT) est proposé pour le traitement de l OM diffus diabétique, pour lequel la photocoagulation a un effet décevant. Nous rapportons les résultats de deux études de phase 2 sur l effet et la tolérance d une injection unique d AT chez des patients présentant un OM diabétique réfractaire à la photocoagulation. Le critère principal était l épaisseur maculaire mesurée par tomographie en cohérence optique et les critères secondaires l acuité visuelle (AV), la pression intraoculaire et l opacification cristallinienne. La première étude incluait 17 patients présentant un OM bilatéral ; un œil était traité par 4 mg d AT, l œil adelphe servait de contrôle (séries appariées). Après traitement ont été constatés une diminution de l épaisseur maculaire et un gain d AV significatifs à 4 et 12 semaines. Une hypertonie était retrouvée dans 9 yeux injectés sur 17. La seconde étude comparait 4 mg et 2 mg (16 yeux de 16 patients pour chaque dose) ; il n a pas été mis en évidence de différence entre les deux groupes pour l amplitude et la durée de la diminution de l épaisseur maculaire, l AV, ou l augmentation de la pression intraoculaire. Secondairement l ensemble des données obtenues par OCT a été traité par une méthode de modélisation pharmacocinétique-pharmacodynamie de population, avec des résultats cohérents, permettant de calculer des paramètres pharmacologiques d intérêt sans mesure directe de concentrations.Macular edema (ME) is the main cause of visual impairment in diabetic patients. Its treatment is based on tight control of glycemia and blood pressure, and on macular laser photocoagulation. Since 2001, Triamcinolone Acetonide (TA) is proposed as a treatment for diffuse diabetic ME, for which photocoagulation is disappointing. We report the results of two phase 2 trials studying the effect and safety of an injection of TA in patients suffering from ME refractory to photocoagulation. Main endpoint was central macular thickness measured by optical coherence tomography; secondary endpoints were visual acuity (VA), intraocular pressure and lens opacification. The first study included 17 patients with bilateral DME; one eye was treated by 4 mg of TA, the other eye served as control (paired series). After TA injection, central macular thickness significantly decreased and a significant VA gain was observed after 4 and 12 weeks. Ocular hypertension was observed in 9 of the 17 injected eyes. The second study compared 4 mg to 2 mg (16 eyes of 16 patients in each group). This study was unable to find any significant difference between the two groups in terms of magnitude and duration of central macular thickness decrease, neither on VA and intraocular pressure increase. The whole data from OCT measurements were then studied by population pharmacokinetic-pharmacodynamic modeling, producing coherent results, allowing calculation of pharmacological parameters as vitreous elimination half-life, without any direct concentration measure. We suggest this method could replace classical ocular pharmacokinetic studies, which necessitate invasive proceduresPARIS-BIUP (751062107) / SudocSudocFranceF

Ces ‘virus ambulants’. Discours et pratiques à l’égard des filles de justice atteintes de maladies vénériennes (Belgique, 1912-1950)

Discusses two intertwined phenomena that emerged during the 19th and 20th centuries and that developed until World War II, namely, the implementation of the "child protection" system, on the one hand, within which juvenile courts were set up and a specific justice was applied to minors, and an active health policy, on the other hand, which was strengthened during both world wars, and that particularly applied to venereal diseases. Among the cases presented before the juvenile courts, there was a particular concern for the sexuality of young women, potentially under the threat of a series of irreversible "risks" - premarital sex, early pregnancy, prostitution, and venereal diseases. Through a double sociological and medical argumentation, these were considered as risks not only for the young woman but also for those she might contaminate, for her future children, for the preservation of morality, and even "race." Although some sources from minors' protection institutions show that boys appeared as likely to be contaminated by these diseases as girls, the criminological views and screening practices were only applied to young women. In the wake of World War I, much was spent to treat and reeducate these young women in institutions for minors, testimony to the fears raised by this issue. The government dedicated its full attention to the issue by creating the Asile-Clinique in Bruges. For decades, juvenile court judges sent their wards to these institutions so that they could benefit from state-of-the-art medical treatment and educational measures. The organization and the treatments that were provided in these institutions, a complex mix of moral and medical considerations, were a practical example of the convergence of interests between health concerns of the medical body and the project of the "remoralization" of female youth, as it was supported by the practitioners of child protection during the first half of the 20th century