The detection of intentional contingencies in simple animations in patients with delusions of persecution

Background. It has been proposed that delusions of persecution are caused by the tendency to over-attribute malevolent intentions to other people's actions. One aspect of intention attribution is detecting contingencies between an agent's actions and intentions. Here, we used simplified stimuli to test the hypothesis that patients with persecutory delusions over-attribute contingency to agents' movements. Method. Short animations were presented to three groups of subjects: (1) schizophrenic patients; (2) patients with affective disorders; and (3) normal control subjects. Patients were divided on the basis of the presence or absence of delusions of persecution. Participants watched four types of film featuring two shapes. In half the films one shape's movement was contingent on the other shape. Contingency was either ‘intentional’: one shape moved when it ‘saw’ another shape; or ‘mechanical’: one shape was launched by the other shape. Subjects were asked to rate the strength of the relationship between the movement of the shapes. Results. Normal control subjects and patients without delusions of persecution rated the relationship between the movement of the shapes as stronger in both mechanical and intentional contingent conditions than in non-contingent conditions. In contrast, there was no significant difference between the ratings of patients with delusions of persecution for the conditions in which movement was animate. Patients with delusions of persecution perceived contingency when there was none in the animate non-contingent condition. Conclusions. The results suggest that delusions of persecution may be associated with the over-attribution of contingency to the actions of agents

Silicone migration to the contralateral axillary lymph nodes and breast after highly cohesive silicone gel implant failure: a case report

Highly cohesive silicone gel implants are advertised for aesthetic and safety advantages. Our case is the fourth report describing early implant rupture and contralateral migration of siliconoma. Despite the greater degree of gel cohesiveness, a continued vigilance for signs and symptoms of migration is highly recommended

Une poétique du malaise : les anciens combattants face aux mythes de l’arrière (H. Barbusse, L.-F. Céline, L. Guilloux, E. M. Remarque, L. Werth)

Un bon nombre de romans européens des années 1910 à 1930 ayant pour thème l’expérience des combattants de la Grande Guerre, mettent en scène, à l’occasion de la démobilisation ou d’une permission de ces soldats, le malaise de ceux-ci face à la représentation déformée que le monde civil a de la guerre. Les combattants découvrent des civils qui se veulent, du fait de leur engagement « moral », aussi « héroïques » qu’eux, qui contestent leur vision « partielle » de l’état du front en prétendant à une « hauteur de vue » seule offerte par le recul de l’arrière. Pour représenter ce choc, le roman est d’autant plus efficace qu’il ne se livre pas à une rhétorique de la dénonciation : les personnages de combattants en question sont à la fois révoltés et passifs, opposés mais d’une certaine manière soumis à ces discours de la manipulation. Le « contre-récit » romanesque travaille donc de l’intérieur les discours manipulés, et n’offre pas pleinement les armes intellectuelles, idéologiques, pour s’en défaire : il invite le lecteur à s’interroger sur ces discours sans lui offrir, au-delà du pacifisme commun aux auteurs cités, la solution d’un engagement politique précis

Feasibility criteria for total thyroidectomy in outpatient surgery

INTRODUCTION: France is pursuing a policy of cutting healthcare costs, and outpatient surgery is one of the objectives of this policy. Thyroid surgery could be suitable for outpatient management, provided there is an appropriate patient selection process. The aim of this study was to assess the risk factors for postoperative complications in total thyroidectomy (TT). DESIGN: A single-center observational study was carried out from January 2010 to December 2015. METHOD: Correlations between, on the one hand, age, gender, obesity, history of surgery, antiplatelet and/or anticoagulation treatment, the surgeon\u27s experience, surgery time, repeated lymph node dissection, and surgical indication (cancer, lymphocytic thyroiditis, Graves\u27 disease or multinodular goiter) and, on the other hand, onset of postoperative complications (postoperative hypocalcemia, uni- or bi-lateral lesions of the recurrent laryngeal nerves, and premature compressive hematoma) were assessed. RESULTS: Four hundred and twenty-four consecutive TTs were included. 85 patients showed postoperative hypocalcemia (20.04%), 18 recurrent laryngeal nerve lesion (4.25%), and 4 compressive cervical hematoma (0.94%). Overall morbidity was 24.06%. Risk factors identified for postoperative hypocalcemia comprised: female gender [OR=3.2584; 95%CI (1.5500-7.7515); P=0.0036], surgery time [OR=1.0095; 95%CI (1.0020-1.0172); P=0.0129], and surgical indication for benign adenoma [OR=5.0642; 95%CI (1.7768-14.5904); P=0.0022]. None of the study variables emerged as risk factors for recurrent laryngeal nerve lesion. Repeated dissection increased the risk of re-do surgery for compressive hematoma [OR=25.1373; 95%CI (0.8468-32.2042); P=0.0347]. CONCLUSION: Surgery time, female gender, repeated dissection and total thyroidectomy for benign adenoma are risk factors that should be considered in decision-making for performing TT on an outpatient basis