Approche comprehensive du meurtre et des meurtriers dans une perspective psychobiologique

A fraca incidência de perturbações mentais como determinantes do comportamento homicida reduziu o interesse das classificaões psiquiátricas geralmente utilizadas. O objectivo deste artigo é o de apresentar uma nova categorização, elaborada a partir de observações realizadas no quadro de exames médico-legais de 90 homicidas - 75 homens e 15 mulheres. Os autores sublinham O interesse de uma categorização que tenha em conta, numa dupla perspectiva psicobiológica e psicodinâmica, as dimensões motivacionais e relacionais. Em relação ao eixo motivacional, distinguem a conduta aversiva - (a) - que visa «pôr fim a uma emoção dolorosa episódica ou a uma dor moral mais durável, ao agir sobre a situação que lhe esteve na origem» (Karli, 1987), da conduta apetitiva - (b) - cujo objectivo é o de se (apropriar de um objecto cobiçado e que se pretende possuir com antecipação da emoção agradável que dai é suposto resultar. » No que respeita ao eixo relacional, distinguem homicídios cometidos na Pessoa de indivíduos próximos e familiares - (c) - e na Pessoa de desconhecidos e não-familiares - (d).Aplicado ao estudo dos Potenciais Lentos Cerebrak, cujo interesse esta demonstrado no conhecimento em processos cognitivos e emocionais e nos fenómenos neurobiológicos subjacentes, este sistema classificatório revelou-se particularmente pertinente. Permitiu esclarecer, ao níve1 dos parâmetros de Amplitude e de duração da Variação Contingente Negativa, diferenças significativas entre os perfis apurados em duas categorias tipicas: por um lado, os homicidas passionais - (a) e (c) - e , por outro lado, os psicopatas que cometeram crimes com fins lucrativos - @) e (d) -. Nos primeiros, aumento da amplitude e duração prolongada; nos segundos, amplitude fraca e duração breve.En Psychologie Criminelle, il est bien établi que la faible incidence des maladies avérées dans la détermination des conduites meurtriéres réduit la portée des classifications d’inspiration psychiatrique généralement utilisées. Aussi, à partir d’observations réalisées dans le cadre s’expertises pénales chez 90 meurtriers - 75 hommes et 15 femmes -, les auteurs soulignentils l’intérêt d’une catégorisation qui prendrait en compte, dans une double perspective psychobiologique et psychodynamique, les dimensions motivationnelles et relationelles, opposant, la premiére les conduites «aversives» - (a) - visant à (mettre un terme à une émotion douloureuse épisodique ou à une douleur morale plus durable, en agissant sur la situation qui l’avait sucitéen (Karli, 1987), aux conduites «appétitives» - (b) -, dont le but est de ((s’approprier un objet convoité et qu’on entend posséder avec anticipation de l’émotion plaisante qui est censée en résulter», la seconde, par référence au statut de la victime par rapport à l’auteur, meurtres commis sur des personnes proches et familières - (c)-, et à l’inverse, meurtres commis sur des personnes étrangéres et non-familières - (d). Appliqué à l’étude des Potentiels Lents Cérébraux, potentiels dont on sait l’intérêt qu’ils présentent dans l’approche des processus cognitifs et émotionnels et des phénoménes neurophysiologiques qui les sous--tendent, ce systéme classificatoire s’est révélé particulliérement pertinnent et a permis de dégager au niveau des paramètres d’Amplitude et de Durée de la Variation Contingente Négative, des différences significatives entre les profils relevés dans deux catégories typiques, les meurtriers passionnels, d’une part - (a) (c) - et les psychopathes auteurs de crimes visée lucrative d’autre part - (b) (d) - amplitude augmentée et durée prolongée chez les premiers, faible amplitude et durée bréve chez les seconds.The Weak incidence of mental diseases in inducing murderous behaviour has reduced the interest of psychiatric classifications as they have been used in criminal Psychology. The aim of this paper was to present a new categorization which has been elaborated from a study carried out on 90 murderers - 75 males and 15 females - examinated in the framework of expert’s reports requested by Cnminal Courts. This categorization emphasises individual differences and takes into account both motivation and interpersonal relationships of the murderers Thus, according to the motivation axis, the authors distinguished aversive behaviour (a) which aims «to put a term to either a painful emotional episode or a long lasting worrying by acting-out upon the situation which has given rise to it» (Karli, 1987), from appetitive behaviour (b) which consists (do wish to appropriate and to possess a coveted object with anticipation of the pleasant emotion which is supposed to result)). Moreover, according to the interpersonal relationship axis, they distinguished murders committed against familiar and closely related people (c), from those committed against non-familiar and unknown people (d). This categorization appeared as relevant when applied to a murder’s psychophysiological approach using Cognitive Event Related Potentials (ERPs). It is well knowwn that ERPs and in particular Contingent Negative Variation (CNV) are modulated by cognitive, emotional and neurochemical facttors. Thus, the murderers Who committed crimes of passion - (a) (c) - displayed high amplitude and long duration CNV while antisocial psychopaths Who killed with an utilitarian incentive - @) (d) - displayed low amplitude short duration CNV

Helical Chirality: a Link between Local Interactions and Global Topology in DNA

DNA supercoiling plays a major role in many cellular functions. The global DNA conformation is however intimately linked to local DNA-DNA interactions influencing both the physical properties and the biological functions of the supercoiled molecule. Juxtaposition of DNA double helices in ubiquitous crossover arrangements participates in multiple functions such as recombination, gene regulation and DNA packaging. However, little is currently known about how the structure and stability of direct DNA-DNA interactions influence the topological state of DNA. Here, a crystallographic analysis shows that due to the intrinsic helical chirality of DNA, crossovers of opposite handedness exhibit markedly different geometries. While right-handed crossovers are self-fitted by sequence-specific groove-backbone interaction and bridging Mg2+ sites, left-handed crossovers are juxtaposed by groove-groove interaction. Our previous calculations have shown that the different geometries result in differential stabilisation in solution, in the presence of divalent cations. The present study reveals that the various topological states of the cell are associated with different inter-segmental interactions. While the unstable left-handed crossovers are exclusively formed in negatively supercoiled DNA, stable right-handed crossovers constitute the local signature of an unusual topological state in the cell, such as the positively supercoiled or relaxed DNA. These findings not only provide a simple mechanism for locally sensing the DNA topology but also lead to the prediction that, due to their different tertiary intra-molecular interactions, supercoiled molecules of opposite signs must display markedly different physical properties. Sticky inter-segmental interactions in positively supercoiled or relaxed DNA are expected to greatly slow down the slithering dynamics of DNA. We therefore suggest that the intrinsic helical chirality of DNA may have oriented the early evolutionary choices for DNA topology

Year in review in Intensive Care Medicine 2012. II: Pneumonia and infection, sepsis, coagulation, hemodynamics, cardiovascular and microcirculation, critical care organization, imaging, ethics and legal issues.

Journal ArticleSCOPUS: re.jSCOPUS: re.jinfo:eu-repo/semantics/publishe

Prostate cancer and solid organ transplantation: Patient management and outcomes

Objective: To analyse the management and outcomes of individuals diagnosed with prostate cancer either before or after organ transplantation, as the impact of organ transplantation and associated immunosuppression on the incidence, progression, and mortality of prostate cancer remains an area of substantial clinical interest and uncertainty. Patients and methods: We conducted a retrospective analysis of patients from two tertiary care centres who had solid organ transplantation and were diagnosed with prostate cancer before or after organ transplantation. Data collected included demographics and clinical information. Results: The cohort consisted of 110 patients with a median (interquartile range [IQR]) age at prostate cancer diagnosis of 62 (56.6-67.2) years and a median (IQR) age at transplantation of 58.6 (52.7-65.3) years. Renal transplantation was the most common (54%). The median (IQR) prostate-specific antigen concentration at prostate cancer diagnosis was 6.2 (4.5-10) ng/mL, and the distribution of American Urological Association risk groups was: low risk, 36%; intermediate risk, 50%; and high risk, 14%. In all, 45 (41%) patients were diagnosed with prostate cancer prior to transplantation. Management included radical prostatectomy (RP; 62%), prostate radiotherapy (RT; 13%), and active surveillance (AS; 18%). During a median (IQR) follow-up of 5.8 (2.5-10) years from prostate cancer diagnosis, one (2%) patient developed metastatic disease. In all, 65 (59%) patients were diagnosed with prostate cancer subsequent to organ transplantation. Management included AS (29%), RT (45%), and RP (15%). During a median (IQR) follow-up of 5.3 (1-8.4) years, three patients (5%) developed metastatic disease. There were no deaths from prostate cancer. Conclusion: A diagnosis of localised prostate cancer should not preclude solid organ transplantation, and the presence of a transplant does not appear to substantially impact risk of prostate cancer progression.</p

Early Clinical Differentiation of Cerebral Infarction from Severe Atherosclerotic Stenosis and Cardioembolism

Background and Purpose: Hyperacute Cerebral Infarction Trials Require Early Differentiation of Infarction Subtype. Our Aim Was to Determine Clinical Factors Predictive of Infarction Subtype from Data Collected in the Early Hours of Admission. Methods: using the 1,273 Patients Enrolled in the Stroke Data Bank, Stroke Risk Factors and Demographic, Clinical, and Radiological Features Were Compared between the 246 Cardioembolic and 113 Large-Vessel Atherosclerotic Cerebral Infarcts. Results: Stroke Data Bank Definitions Ensured More Transient Ischemic Attacks in Atherosclerotic Infarcts and More Cardiac Disease in Cardioembolic Infarcts, But the Diagnosis Was Distinguished Further using a Logistic Regression Model. Fractional Arm Weakness (Shoulder Different from Hand) (Odds Ratio 3.1, 95% Confidence Interval [CI] 1.6-5.8), Hypertension (Odds Ratio 2.8, CI 1.4-5.3), Diabetes (Odds Ratio 2.5, CI 1.2-5.1) and Male Gender (Odds Ratio=2.2, CI 1.2-4.1) Occurred More Frequently in Patients with Atherosclerotic Than Cardioembolic Infarcts. Reduced Consciousness (Odds Ratio=3.2, CI 1.4-7.3) Was More Frequent in Cardio embolism. for a Male Patient with Hypertension, Diabetes, and Fractional Arm Weakness, the Estimated Odds of an Atherosclerotic Infarction Were 47-Fold that of a Cardioembolic Infarction. Patients with Atherosclerotic Infarcts Were More Likely to Have a Fractional Arm Weakness Regardless of Infarct Size, Whereas, for Those with Cardioembolic Infarctions, Fractional Weakness Was More Frequent in Infarcts Less Than 20 Cc in Volume. Conclusions: Clinical Features that Are Observed at Stroke Onset Can Help Distinguish Cerebral Infarction Subtypes and May Allow for Early Stratification in Therapeutic Trials. © 1992 American Heart Association, Inc

New materials and devices for preventing catheter-related infections

Catheters are the leading source of bloodstream infections for patients in the intensive care unit (ICU). Comprehensive unit-based programs have proven to be effective in decreasing catheter-related bloodstream infections (CR-BSIs). ICU rates of CR-BSI higher than 2 per 1,000 catheter-days are no longer acceptable. The locally adapted list of preventive measures should include skin antisepsis with an alcoholic preparation, maximal barrier precautions, a strict catheter maintenance policy, and removal of unnecessary catheters. The development of new technologies capable of further decreasing the now low CR-BSI rate is a major challenge. Recently, new materials that decrease the risk of skin-to-vein bacterial migration, such as new antiseptic dressings, were extensively tested. Antimicrobial-coated catheters can prevent CR-BSI but have a theoretical risk of selecting resistant bacteria. An antimicrobial or antiseptic lock may prevent bacterial migration from the hub to the bloodstream. This review discusses the available knowledge about these new technologies

Delayed Treatment with Systemic (S)-Roscovitine Provides Neuroprotection and Inhibits In Vivo CDK5 Activity Increase in Animal Stroke Models

Although quite challenging, neuroprotective therapies in ischemic stroke remain an interesting strategy to counter mechanisms of ischemic injury and reduce brain tissue damage. Among potential neuroprotective drug, cyclin-dependent kinases (CDK) inhibitors represent interesting therapeutic candidates. Increasing evidence indisputably links cell cycle CDKs and CDK5 to the pathogenesis of stroke. Although recent studies have demonstrated promising neuroprotective efficacies of pharmacological CDK inhibitors in related animal models, none of them were however clinically relevant to human treatment.In the present study, we report that systemic delivery of (S)-roscovitine, a well known inhibitor of mitotic CDKs and CDK5, was neuroprotective in a dose-dependent manner in two models of focal ischemia, as recommended by STAIR guidelines. We show that (S)-roscovitine was able to cross the blood brain barrier. (S)-roscovitine significant in vivo positive effect remained when the compound was systemically administered 2 hrs after the insult. Moreover, we validate one of (S)-roscovitine in vivo target after ischemia. Cerebral increase of CDK5/p25 activity was observed 3 hrs after the insult and prevented by systemic (S)-roscovitine administration. Our results show therefore that roscovitine protects in vivo neurons possibly through CDK5 dependent mechanisms.Altogether, our data bring new evidences for the further development of pharmacological CDK inhibitors in stroke therapy