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Background : The systematic approach to sexuality in general medicine allows patients, among other things, to know that they can consult their doctor for questions in the area of sexual health. The objective of the study is to determine what type of questioning is most acceptable to the patient during the onset of sexuality by the general practitioner. The secondary aim is to assess the influence of the kind of interrogation on the surprise, the discomfort of the patient and on the course of the consultation.Method : A quantitative, transversal, descriptive, declarative, monocentric study was carried out. One group received a single themed question and the other group received a multi-themed question. The study was carried out using a self-administered questionnaire in a general practice located in Saint Drézéry, Hérault, France, by a male substitute doctor. The rate of patients who rated the physician's approach as acceptable was the primary outcome.Results : 171 patients were included in the study, including 85 for the "single theme" group and 86 for the "multiple themes" group. The two groups were statistically similar. 97.5 % of patients in the “single theme” group and 100 % of patients in the “multiple themes” group declared that they considered the question acceptable (P = 0.25).Conclusion : The study failed to demonstrate a significant difference between the two methods in terms of acceptability. The “multiple themes” method seems to cause less discomfort for the patient. It makes the doctor feel more comfortable and leads to an equivalent rate of discussion about sexuality. In this sense, the question "multiple themes" seems the most appropriate.; Introduction : L’abord systématique de la sexualité en médecine générale permet aux patients entre autres de savoir qu’ils peuvent consulter leur médecin traitant pour des questions du domaine de la santé sexuelle. L’objectif de l’étude est de déterminer quel type d’interrogatoire est le plus acceptable pour le patient lors de l’abord de la sexualité par le médecin généraliste. L’objectif secondaire est de déterminer l’influence du type d’interrogatoire sur la surprise, la gêne du patient et sur le déroulement de la consultation.Méthode : Une étude quantitative, transversale, descriptive, déclarative, monocentrique a été réalisée. Un groupe a reçu une question à thème unique et l’autre groupe une question à thèmes multiples. L’étude a été menée par le biais de questionnaire autoadministré au sein d’un cabinet de médecine générale situé à Saint Drézéry, Hérault, France par un médecin remplaçant homme. Le taux de patients évaluant la démarche du médecin comme acceptable était le critère de jugement principal.Résultats : 171 patients ont été inclus dans l’étude dont 85 pour le groupe « thème unique » et 86 pour le groupe « thèmes multiples ». Les deux groupes étaient statistiquement similaires. 97,5 % des patients du groupe « thème unique » et 100 % des patients du groupe « thèmes multiples » ont déclaré considérer la question comme acceptable (p = 0,25).Conclusion : L’étude n’a pas permis de démontrer une différence significative entre les deux méthodes pour l’acceptabilité. La méthode « thèmes multiples » semble entraîner moins de gêne chez le patient. Elle permet au médecin de se sentir plus à l’aise et elle entraîne un taux de discussion sur la sexualité équivalent.

Dans ce texte, l’auteure dresse un portrait de la position de D’abord solidaires, collectif de lutte contre la montée d’idées de droite, en ce qui concerne la question du bien commun. Françoise David dénonce l’idée du bien commun que peuvent se faire nos élites politiques en démontrant les dangers qui guettent les sociétés qui négligent de prendre en considération les conséquences à long terme des actions de celles-là. Pour D’abord solidaires, le bien commun en appelle plutôt à l’idée d’une communauté des êtres humains, à une vision qui nous entraîne à rechercher l’intérêt général, un partage de la richesse, des savoirs, des beautés de la nature, une reconnaissance de notre interdépendance et, donc, de notre besoin de solidarité. In this article, the author presents the position of D’abord solidaires, a collective opposing the rise of right wing ideas, on the issue of the common good. Françoise David denounces the idea of the common good often held by the political elites and shows us the dangers threatening societies which fail to take into consideration the long-term consequences of their actions. For D’abord solidaire, the common good relates above all to the idea of a community of human beings; a vision that leads us to seek the general interest; a sharing of wealth, knowledge and the beauties of nature; a recognition of our interdependence and, therefore, our need for solidarity.

The aim of this open trial was to assess the efficacy and the safety of interferon (IFN) alfa therapy in liver transplant recipients with chronic active hepatitis caused by hepatitis C virus. In July 1991, among 447 liver recipients regularly observed at our institution, 46 had developed HCV-related chronic active hepatitis defined by piece meal necrosis. Fourteen of these 46 patients received IFN alfa 3 mIU three times weekly for a planned duration of 6 months and were compared to the 32 untreated patients. Genotyping and quantification of viremia were performed using type-specific amplification and branched DNA assay. Histological follow-up was available in all patients and routinely before and after IFN therapy. Treated and untreated patients did not differ regarding gender, age, length of follow-up, maximum histological score, and genotypes (41 of 46 were of type lb). Induction of chronic rejection was observed in 5 of 14 treated patients leading to retransplantation in 3. In contrast, chronic rejection occurred in 1 of 32 untreated patients (P < .005) during the posttransplantation follow-up. Among the 9 treated patients without rejection, a decrease of transaminases or of HCV RNA levels of more than 50% were observed in 8 and 4, respectively; 2 patients had a complete response, and 1 did not relapse after discontinuation of IFN. Histological improvement occurred in 2 of the treated patients and in none of the untreated patients. IFN therapy in liver transplant recipients has poor antiviral effect and can induce chronic rejection. Its use in this setting should be cautious.

Liver transplantation for liver diseases related to hepatitis B virus (HBV) and hepatitis delta virus (HDV) remains problematic because of the risk of viral recurrence. We report here the long-term virological outcome of patients transplanted for HDV-related liver cirrhosis (HDV cirrhosis). From December 1984 to December 1990, 76 patients with HDV cirrhosis underwent liver transplantation. Before transplantation, all the patients were HBsAg-positive/anti-HDV positive, and all but one were HBV DNA-negative by dot blot hybridization. HDV RNA was detected by HDV RT-PCR and liver HDAg by fluorescent HDV Ab. After transplantation, all the patients except four received continuous long-term anti-HBs passive immunoprophylaxis. The actuarial 5-year survival was 88%. All patients who did not receive anti-HBs immunoprophylaxis remained HBsAg-positive and developed hepatitis. Among the 68 patients receiving antiHBs immunoprophylaxis with a minimum follow-up of 2 months, HBsAg reappeared in 7 (10.3%) after a mean of 17 months. These seven patients developed hepatitis, with simultaneous HBV and HDV replication; and four cleared later HBsAg. Patients without HBV reinfection were studied for HDV reinfection: liver HD Ag or serum HDV RNA were present in 88% of the patients during the first year, without developing hepatitis; however, they were no longer detectable after 2 years in 95% of the patients. In conclusion, liver transplantation for HDV cirrhosis gives good results, with a 5-year actuarial survival of 88%.(ABSTRACT TRUNCATED AT 250 WORDS)

Orthotopic liver transplantation in patients with hepatitis B-related cirrhosis is commonly complicated by reinfection with the hepatitis B virus, with rapidly progressive liver disease and poor survival rate. We assessed the efficacy of prior therapy with recombinant interferon-alpha on the prevention of posttransplantation hepatitis B virus reinfection. Twenty-two patients with hepatitis B-related cirrhosis waiting for liver transplantation received 3 MU (decreased to 1.5 MU in cases of intolerance) of recombinant interferon-alpha until transplantation. The rates of posttransplantation hepatitis B virus reinfection and survival in this group were compared with those in a group of 26 patients previously given transplants for the same disease but not given interferon therapy. The same protocol of HBs antibody passive immunoprophylaxis was applied after transplantation in both groups. Recombinant interferon-alpha was administered for 14 +/- 7 wk. The treatment had an antiviral effect, with disappearance of serum hepatitis B virus DNA in seven of the eight patients initially positive for hepatitis B virus DNA and disappearance of HBeAg in two of the three patients initially positive for HBeAg. Serum hepatitis B virus DNA remained detectable with polymerase chain reaction at transplantation in 56% of the interferon-treated patients. After transplantation, hepatitis B virus reinfection was more frequent in polymerase chain reaction-positive than in polymerase chain reaction-negative patients (78% vs. 17%, p < 0.05). One patient's condition deteriorated during interferon treatment; this patient was not given a transplant. Two patients (in whom hepatitis B virus DNA disappeared from serum) improved so markedly during treatment that they were not given transplants.(ABSTRACT TRUNCATED AT 250 WORDS)

This paper revisas Catullus' reception from the point of view of «Decadence». It aims at tracing the influence of Catullus' works on late XlXth century literature. Considered as a victim of a pathological attraction towards Lesbia, the rejected lover is split between body and soul, writing and sex. Using fin de siècle translations of Catullus as well as fin de siècle references to hirn, this article establishes that the decadent interest in Catullus was more acute than has been generally thought. The martyrdom of the «pious poet», despite, or thanks to, the downfall of the Muse (and the parody of the passer poerns), leads to a decadent revival of that almost classical figure. Catullus becomes more than ever the poet of contrasts, the obscene writer of polished poetry in the Alexandrine manner. The scholarly concern for metrical perfection and the technical achievement of his witty poems is of considerabte interest for decadent poetics, as much as his crude poetry., Cet article renouvelle la réception de Catulle dans une perspective décadente, afin de retracer l'influence de l'œuvre catullienne sur la littérature de la fin du XIXe siècle. Considéré comme victime d'une attirance pathologique pour Lesbie, l'amoureux rebuté est partagé entre corps et âme, écriture et sexualité. En utilisant aussi bien des traductions de Catulle que des références fin de siècle, cette étude démontre que l'intérêt de la Décadence pour Catulle était plus important qu'on a bien voulu le dire. Le martyre du «poète pieux», à cause de la décadence de la muse (et des parodies des poèmes sur le moineau), ou grâce à elle, conduit à la renaissance décadente de cette figure plutôt classique. Catulle devient plus que jamais le poète des contrastes, le poète obscène d'une poésie raffinée, à la manière alexandrine. Le souci érudit de la perfection métrique et les prouesses techniques de ses poèmes intéressent au plus haut point la poétique décadente, tout autant que sa poésie obscène., David-de-Palacio Marie-France. Les ciselures de l'amertume : Catulle fin de siècle. In: Romantisme, 2001, n°113. L'Antiquité. pp. 105-116.

Signaling through pathways involving mitogen-activated protein kinases (MAP kinases) has been implicated in the pathogenesis of cancer. Thus, the activity of MAP kinase is essential in the malignant potential of human breast tumors. p42/44(MAPK) was significantly higher expressed in tumor samples than in matching normal tissues adjacent to the tumor. p42/44(MAPK) protein expression correlated with enhanced MAP kinase activity only in a subset of tumors, indicating that over-expression of MAP kinases does not reflect the activation status of these enzymes. MAP kinase activity was significantly elevated in 131 tissue samples from primary breast tumors when compared to 18 normal tissues adjacent to tumors. A trend for higher MAP kinase activity in primary tumors of node-positive patients was observed when compared with tumors from node-negative patients. Similarly, higher MAP kinase activities were observed in specimens from patients who had a relapse within the follow-up time of 40 months when compared with patients with no relapse. A survival analysis demonstrated that the MAP kinase activity in primary breast tumors is potentially prognostic for relapse-free survival of patients.

Background/Aims: Hepatitis B virus (HBV) disease on a liver graft is associated with florid viral replication and graft failure. The aim of this study performed between 1992 and 1995 was to investigate the safety and efficacy of long-term intravenous ganciclovir for HBV infection in liver transplant recipients. Methods: Twelve patients with HBV re-infection and four with de novo HBV infection were studied. HBV DNA was positive in all (median titer: 437.5 pg/ml) and HBeAg was positive in seven. Intravenous ganciclovir was started after a median of 14.5 months from HBsAg positivation and continued for a median of 10 months. Results: A complete response with HBV DNA negativation was seen in ten cases, a partial response with a decrease of more than 50% of initial HBV DNA levels in four and no response in two. Overall tolerance was good. Among the ten complete responders, two seroconverted for both HBsAg and HBeAg and one for HBsAg alone. Among these ten patients, three were re-transplanted for liver failure: two of them are alive; three had a viral breakthrough during treatment; and four remained HBV DNA negative: two are alive and two died. Partial responders and nonresponders were treated with other antiviral agents and three were re-transplanted, two of them are alive. Overall 12 out of 16 patients (75%) survived with a median follow up of 46 months. Conclusions: Long-term intravenous ganciclovir can persistently inhibit HBV DNA replication in liver transplant recipients and is well tolerated. Further evaluation should be encouraged, especially for HBV recurrence after first-line treatments.

In human MCF-7 breast cancer cells, both protein kinase A (PKA) and different members of the protein kinase C (PKC) family are stimulated upon binding of epidermal growth factor (EGF) to cell surface receptors. Selective stimulation of calcium-dependent PKCs with 10(-6) to 10(-9) M Thymeleatoxin significantly increased the proliferation rate of MCF-7 cells over 5 days in culture. This stimulation was blocked by the PKC antagonist Chelerythrine. In contrast, selective activation of PKA by addition of 1 mM dibutyryl cyclic AMP (dBcAMP) did not affect the proliferation rate of MCF-7 cells. Similarly, activation of the adenylate cyclase by 1 microM Forskolin and inhibition of PKA by the cyclic AMP analogue Rp-cAMPS did not modulate the proliferation rate of these cells. Activation of PKC stimulated the expression of the immediate early gene c-fos but c-myc expression was not significantly enhanced. On the other hand, PKA activation increased both c-myc and c-fos expression in MCF-7 cells. These results suggest that PKA activation and c-myc expression are not obligatory for proliferation of MCF-7 cells.

Background/Aims: The aim of this study was to clarify the aetiology of apparent de novo HBV infection after liver transplantation. Methods: Twenty out of 570 HBsAg negative patients (3.5%) became HBsAg positive after transplantation and were studied. Donor and recipient sera were retrospectively tested for HBsAg, anti-HBs, anti-HBc, and HBV DNA by PCR. Donor and recipient livers were tested for HBV DNA by PCR on paraffin-embedded tissue. Results: Group 1: HBV infection of donor origin (eight patients): one donor serum was HBsAg positive, three were serum HBV DNA positive, four were liver HBV DNA positive. Group 2: reactivation of latent HBV infection (eight patients) with detection of HBV DNA in pretransplant serum (seven patients) or in native liver (one patient): three were anti-HBs positive, two anti-HBc positive, and three with fulminant hepatitis had no serological HBV markers. Group 3: undetermined origin (four patients) defined by absence of HBV DNA in pretransplant donor and/or recipient sera and liver; however, acquired infection was suspected from two anti-HBs and anti-HBc positive donors. Two patients became HBsAg negative, and five HBV DNA negative. One died from HBV-cirrhosis and two were retransplanted. In the others, the last histology showed cirrhosis (three), chronic hepatitis (nine), acute hepatitis (one), and non-specific change (four patients). Conclusions: The prevalence of de novo HBV infection in liver transplant patients was 3.5%; the aetiology was determined in 1620 patients: from the donor in eight, and from the recipient in eight. One should be cautions when donors or recipients are anti-HBc or both anti-HBs and anti-HBc positive.

The aim of this open trial was to assess the efficacy and the safety of interferon (IFN) alfa therapy in liver transplant recipients with chronic active hepatitis caused by hepatitis C virus. In July 1991, among 447 liver recipients regularly observed at our institution, 46 had developed HCV-related chronic active hepatitis defined by piece meal necrosis. Fourteen of these 46 patients received IFN alfa 3mlU three times weekly for a planned duration of 6 months and were compared to the 32 untreated patients. Genotyping and quantification of viremia were performed using type-specific amplification and branched DNA assay. Histological follow-up was available in all patients and routinely before and after IFN therapy. Treated and untreated patients did not differ reading gender, age, length of follow-up, maximum histological score, and genotypes (41 or 46 were of type 1b). Induction of chronic rejection was observed in 5 of 14 treated patients leading to retransplantation in 3. In contrast, chronic rejection occurred in 1 of 32 untreated patients (P < .005) during the posttransplantation follow-up. Among the 9 treated patients without rejection, a decrease of transaminases or of HCV RNA levels of more than 50% were observed in 8 and 4, respectively; 2 patients had a complete response, and 1 did not relapse after discontinuation of IFN. Histological improvement occurred in 2 of the treated patients and in none of the untreated patients. IFN therapy in liver transplant recipients has poor antiviral effect and can induce chronic rejection. Its use in this setting should be cautious.

Before the use of highly active antiretroviral therapy ( H M T ) , disseminated Mycobarterium avium complex (DMAC) infection was a common opportunistic infection in adults infected by HIV [l-31. The incidence of this disease increased in the later stage of HIV infection, occurring in 15-24% of cases [2,4]. Previous studies had shown that DMAC infection was associated with shorter survival and that antimycobacterial treatment improved survival [5-81. However, mortality was still high, due to the deep underlying immunodeficiency and because diagnosis is reached after a long period of silent mycobacterial replication, a phenomenon emphasized by the time (3-4 weeks) required for diagnosis through conventional cultures. Finally, antimycobacterial treatment is often started late, which is prejudicial for patients already severely ill [6]. Such reasons support the concept of prophylaxis with rifabutin [4], clarithromycin [9], azithromycin or a combination of azithromycin and rifabutin [lo] in patients presenting an advanced immune deficiency (lower than 100/mm3). However, clarithromycin monotherapy may select resistant Mycobacteriurn avium complex (MAC) [7], and the large number of drugs required by the immune condition at this stage of the disease may affect compliance with prophylaxis.

Die «Vieille Morte» (alte Tote) ist eine Erzählung aus den Cevennen, die die Autoren in mehreren, sehr verschiedenen mündlichen Fassungen gesammelt haben. Mittels der uns zugekommenen Elemente ist es schwer, die Bedeutung dieser Geschichte zu erfassen ; jedoch dank gewissen strukturellen Schemata, konnten die Autoren die Grundskizze einer Interpretation anbienten., La Vieille Morte is a tale from the Cevennes, whose authors have come across several very different oral, versions. It is not easy to perceive the meaning of the story through those elements which have reached us ; however, by resorting to certain structural patterns, the authors have been able to suggest the outline of an interpretation., La Vieille Morte est un conte cévenol dont les auteurs ont recueilli plusieurs versions orales, fort différentes. Il n'est pas aisé de percevoir la signification de ce conte à travers les éléments qui nous en sont parvenus ; cependant, grâce au recours à certains schèmes structurels, les auteurs ont pu proposer les linéaments d'une interprétation., La Vieja Muerta es un cuento de los Cevennes del que los autores recogieron varias versiones orales, muy diferentes. No es fácil descubrir el significado de este cuento a través de los elementos que han llegado hasta nosotros ; sin embargo recurriendo a ciertos esquemas estructurales, los autores pueden proponer los hilos de una interpretación., Dufeil Michel-Marie, Millan Dominique, David Françoise. La vielha morta, essai sur un conte cévenol. In: Cahiers de Fontenay, n°23, 1981. Écrit/Oral. pp. 43-63.