here your doctor

After its opening, the Maison de Solenn - home adolescents Paris is proud of its medical officer , Professor Marcel Rufo , and the President of the Hospital Foundation Paris -Hôpitaux de France , Bernadette Chirac , the origin of project whose operations Parts Yellow conducted annually with the same ardor led funding.
A home from home ... for young people suffering
Inaugurated on 17 November 2004, the Maison de Solenn -House Youth opened its doors to the public on the website of the Groupe Hospitalier Cochin -Saint Vincent de Paul La Roche - Guyon, in Paris.

This house, whose architecture and design make it a unique place of its kind , is part of the housing program developed by the Youth Foundation to help young people suffering.

Together in one place a wide range of disciplines and skills necessary to support effective and efficient adolescents, it is at once a place of welcome , prevention , information , care and monitoring teaching and research , said Bernadette Chirac , during a press conference to take stock after six months of operation.

The President of the Foundation also recalled that two houses of adolescents had been inaugurated in 2004 , one in Rouen , the other in Reims, and five new projects were underway in 2005 ( Caen, Dax , Pontoise, Rennes , Macon ) .

Nearly 15,000 teenagers acceuillis
Since its opening , 14,727 teenagers were welcomed ( in person or by telephone) or received an interview , and 4349 had a multidisciplinary consultation , said Dr. Rufo .

After a very strong attendance (800 per month ), medical consultations saw their numbers stabilize at 500 per month. In 90% of cases it is the spontaneous initiative of adolescents or their parents requests , said the psychiatrist .

Between January and May 2005, 70 young people were hospitalized for medical or stay six days on average, for support of their eating disorders for about 3 months, for psychological disorders (depression , impaired personality , phobias ... ) for 3 weeks or emergency in one of two beds reserved for this purpose.

La Maison de Solenn is also a victim of its success , since many young people who use this structure are being directed to other care facilities for lack of space , laments with Reuters Health Pierre Bert frame nurse.

The therapeutic foster part-time center ( CATTP ) hosted 26 teenagers at two workshops per week . Very popular with teenagers , they are prescribed by doctors as cultural care in addition to medical care. They are an opportunity for some to "discover new things " like singing or piano , testified Valentine, 15, who made ​​a one-month stay at the Maison de Solenn . And most importantly they allow therapists to work on the problem of narcissism , which is the common problem of all these young people, says senior nurse .

According to him, the 15-16 age group represents the majority of adolescents received. The largest group consists of those who suffer from eating disorders . A kitchen is also specially designed for people suffering from anorexia , where a dietitian prepare a "minimum" menu.

For Valentine, the Maison de Solenn differs from conventional hospital units with " humanity and understanding " shown by caregivers . Same observation from Jeremy, 18, ​​for whom the success of this institution is the quality of the people who work there . "These people must be picked " , was he exclaimed.

Very surrounded both by the medical staff and other young people that they recognize , they return regularly , by appointment or unannounced, to find " the energy that allows them to move the before . " Recognizing that they do not yet feel ready to move on from this " crutch " , they rely on the continuation of French courses during the stay to facilitate their return to "real life ."

Treat depressive , it is also protecting his family , the occurrence of this disease can cause the " explosion" of a family, said Dr. Sami- Paul Tawil , psychiatrist ( Saint-Antoine Hospital , Paris ) during the " day European depression . "
In a book entitled " The Mirror of Janus , understand and treat depression and manic depression," the practitioner devotes an entire chapter to the impact of the disease on the patient's environment and the role of family.

Characterized by the persistence of a melancholic state , depression has many faces . It can also alternate with periods of elation , signature of manic depression . But by providing a common approach to diseases that affect the mood in France over four million people a year , Dr. Tawil tries to demonstrate in his guide of the disease, they are not inevitable. If the conditions are met.

" A previously welded family can literally explode ' when one of its members is diagnosed manic-depressive ," he warns. There is sadness , surprise and especially an almost palpable fear. " With manic depression , we can talk about chain reactions and ricochets unconscious . Everything telescope with brutality in anguish and sometimes in violence," he said. Guilt , shame, anxiety, despondency and anger are also conventional reactions , he says.

The role of the family is yet to provide full support , says he , " without love and friendship, the best drugs and the best psychotherapy is not enough that a manic-depressive illness effectively fights " . But he also warns , "love does not pay in excess : criticize or infantilizing a sick person équivant to freeze in his illness, to stifle his personality and help take action ."

In fact , he says , the whole family needs help to reach the patient support . And talk with the doctor is the first step . It may eventually offer family therapy in addition to individual therapy , because in all cases , the parent and children suffer too much power to bear alone and unaided the new situation.

Providing assistance to caregivers , Sami -Paul Tawil provides twelve recommendations to close a manic-depressive . Among these , the practitioner advises not to preach , to banish all emotional blackmail , not to resort to the threat.

These tips are all ways to help patients to protect loved ones.

A large European study on mortality from lung cancer in women showed an increase in all European countries except six of the 33 studied.
The study, published on the website of the " Annals of Oncology" , focused on women aged 20-64 years in the 25 countries of the European Union , the countries of Eastern Europe and Russia.

It shows that female mortality from lung cancer increased from 7.8 per 100,000 women in the early 80s to 11.2 per 100,000 in 2000-01. For comparison, the mortality rate is 24 deaths per 100,000 in the United States, where lung cancer has become the leading cause of cancer deaths among women.

The authors calculated that in Europe, mortality increased at an annual rate of 1.5% between 1965 and 1971 , 2.6% between 1972 and 1987 and 1.4% from 1998 to the end of the study.

An analysis by age was performed. Between the early 90s and 2000-01 mortality in younger ( 20-44 years ) increased by 11.41% against an increase of 21.1 % in older ( 35-64 years).

If the overall lower number of deaths among younger women make slightly less clear figures , the trend is proved " more favorable" than in the group of older women , the authors write .

" If effective interventions against tobacco are implemented with women, the epidemic of lung cancer among European women should not reach the levels seen in the United States," they say.

England and Wales of Wales are among the countries where the mortality at all ages has declined in recent years ( with Latvia , Lithuania , Russia and Ukraine ), although the rates are still very high (19.75 deaths per 100,000 ) . Younger British women , the rate has dropped, from 1.56 per 100,000 in 1990-1991 to 1.19 per 100,000 in 2000-2001.

In France , the mortality for all age groups increased steadily, reaching 7.31 per 100,000 in 2000. French youth , the rate almost doubled between 1990 to 1991 (1.08 per 100,000 ) and 2000 (2.12 per 100,000 ) .

While France may be expected that this mortality rate continues to increase due to the number of smokers in the long term , the country should be able to record a decline since the number of new smokers began to decline , told Reuters Health lead author Dr. Cristina Bosetti , Institute of pharmacological research in Milan.

To reduce mortality , it recommends that governments not only increase taxes on tobacco and to ban smoking in public places , but also to target women and children in campaigns against smoking.

The highest mortality rates in countries such as the UK can be attributed to new habits adopted by women in the 40s , said Dr. Cristina Bosetti .

" After the Second World War , the emancipation of women passing by smoking and greater alcohol consumption ( in the UK ) . In countries like France and Italy, this movement came later " she adds .

The high U.S. mortality rates, which decreases after a peak about five years ago to 26 deaths per 100,000 , could be attributed to the same causes, the American who started smoking in the 30s .

The general public and health professionals are waiting for accurate and detailed information on palliative care and more widely on the serious illness , said a summary was published by the Research Centre for the Study and Observation living conditions ( Crédoc ) .
Accompany the end of life of a patient
This paper presents the views of the general population and health professionals not working in a structure on hospice care and support for people in later life . These perceptions were collected between May and July 2003 , with a hundred people being expressed in individual interviews or group sessions, and have been the subject of a report co-authored by the Crédoc and the National Institute for Prevention and health Education ( INPE ) .

Rarely mentioned spontaneously , either by the public or by caregivers, hospice still prove little known , although all agree that their primary objective is to improve the end of life of the patient. They refer to the image of an "alternative medicine " , which is to relieve pain and suffering pain , succeeding the healing phase and lying " between aggressive treatment and euthanasia " can be read in the report.

Among the general public , very few people know the professionals involved in the care of palliative care, and their work is also partly ignored : if the need for training on the psychological aspect is mentioned, no identifies the technical aspects of the occupation.

Accurate, practical and usable
Most healthcare professionals surveyed have meanwhile been unable to mention the structures of palliative care in their area. But even if they do not exercise within a structure of palliative care, " they are likely to make themselves the care or referred to specialized teams ," say Typhaine Mahe , Bruno Maresca and Mary Odile Simon , committee members who conducted the study .

Doctors and nurses are therefore waiting for information , both on the practice of palliative care , in particular the support to which they feel powerless , lack of time and training , and the provision of care existing locally.

The need for "explicit" information and "operational" is also felt for the general public who want to be better prepared to deal with , where applicable, the serious illness of a loved one .

As for the transmission of this information, the wishes of the general population and caregivers meet: the first express the wish " of oral information , targeted and relayed by hospitals and private doctors ," while the latter " want control information (...) , be informed before their patients and the general population ( ... ) and used as privileged actors and relay to the public , " say the authors of the report.

But if this information is required, the professionals interviewed stressed the importance of having sufficient resources to develop the structures first , otherwise all requests can not be met.

Approximately 36 % of the French have abandoned or postponed care or purchase of drugs because of their costs, according to a poll by ViaVoice for interassociative Collective Health (Ciss ) .
This survey was conducted by telephone with 1,004 people. Of all respondents , 90 % had additional health , 45% in individual contracts and 43% in group policy . The beneficiaries of universal health coverage (CMU) represent 13 % of the sample , people in long-term illness (ALD ) 19% .

They are 26% report having had to forego medical care or purchase of drugs "because of the expense incurred ." Some groups are more concerned 38% of CMU beneficiaries , lower at 1,500 euros monthly income (36%) , people with ALD ( 33%), 25-34 years ( 32 %) and private sector employees (30 % ) .

They are also 30 % have decided to postpone such remedies for the same reasons . The categories most affected populations are always the same : the CMU beneficiaries (42%) , lower than 1,500 euros monthly income (38%) , people with ALD ( 37%), 25-34 years ( 40% ) and women ( 35%).

The rate of French to have waived care or to purchase drugs is 41% women and 49% among those aged 25-34 . Among people in ALD , it is 44 % and for CMU beneficiaries , 51 %.

Asked about the transfer of a portion of the expense reimbursements to health complementary health , the French are 73 % believed that this increases health inequalities and 54 % believe that this is the first step towards privatization of health system. However, for 64%, it allows a higher level of reimbursement and 51% , improved quality of care .

They are 35 % think that the increase in contributions to their health could further push to cancel 43% and it could force them to lower -end , taking a less expensive but with more limited coverage contract.

This result corroborates the statement made last week by the health director of the French Federation of Insurance Companies (FFSA ), Alain Rouche , indicating with premium increases , people were " more difficult forward " and they watched " more declines in the levels of safeguards . "

When asked about the priority given by the government to reform the health care system , 43% of French believe that the priority is to reduce the rate of support , 38% that it is to reduce the deficit and save and 26% to reduce the consumption of drugs. Finally, 10% consider that the priority is to improve care and research.

According to interviewees , the priorities should focus on maintaining a good level of reimbursement by health insurance ( 53%), a better distribution of health professionals in the area ( 47%) , improving the equal access to care ( 46%) and quality of care ( 39%) , prevention (33%) , reduced health care costs ( 27%) and the financial stability of health insurance (23 % ) .

In addition , 74 % believe that the State should take all necessary measures to ensure that social security pays the most possible health spending French , while 20 % believe that more people should take charge of this type of expenditure , given the lack of social security.

In a statement, the Ciss denounced the bill funding the Social Security ( PLFSS ) 2011 in which the government introduced measures that " will mainly effect of penalizing users ."

The organization deplores " the lack of political courage that leads to the destabilization of solidarity and universal health insurance coverage for an insured logic " and calls for a " large-scale public debate on the choice of financing of the health system french " .

Soy lowers cholesterol and does not increase the risk of breast cancer, but its use must be tempered by the presentation of Jean- Michel Lecerf , head of the nutrition department at the Pasteur Institute in Lille , Lyonel Rossant , liberal pediatrician and Gwénaële Joubrel , during a roundtable interviews Bichat scientific Director of the French association of traditional soy food manufacturers ( Sojaxa ) at in Paris.
Based on scientific studies , including the report on "Security and benefits of phytoestrogens provided by food - recommendations " of the French Agency for Food Safety ( AFSSA ), the three scientists wished to point on the nutritional benefits of soy foods .

Soy contains isoflavones, polyphenols with low estrogenic activity which gives them the name of " phytoestrogens " . Based on the available toxicity studies , AFSSA recommended limited to 1 mg of isoflavones per kg body weight per day daily intake. "It would consume more than 5 soy products every day to achieve this level of intake ," says the synthesis of roundtable interviews Bichat .

AFSSA has confirmed the interest of consuming soy protein (30 g per day) to lower circulating levels of cholesterol and found that soy isoflavones have a favorable effect on vasotonicité ( from a contribution 45 mg per day) .

" Studies indicate that the incidence of cardiovascular disease is four times lower in Asian countries where the consumption of soy products is higher than in Western countries where it is weak " stress the authors.

Regarding breast cancer , studies show a protective effect of phytoestrogens in Asian women, not transferable to Western women , due to insufficient data . AFSSA concluded , however, that the consumption of soy foods does not increase the risk of developing breast cancer .

In patients with a history of breast cancer , AFSSA recommends not to exceed the daily intake of 1 mg of isoflavones per kg of body weight per day for women who have undergone breast cancer.

Based on childhood soy protein preparations , the three stakeholders indicate that consumption for 40 years in several Western countries demonstrated their equivalence formulas based on cow 's milk proteins . " No adverse effect of soy and / or isoflavones on growth and neuroendocrine development was highlighted in these populations," the report said.

However, the AFSSA report stated that " infants exclusively with preparations of soy protein receive up to 40 times too isoflavones with products currently available on the market ." The agency recommends limiting the intake of phytoestrogens than 1 mg / l of reconstituted " given the current state of knowledge and uncertainty about the long- term" preparation .

The main advantages of soy intake reside in a high amount of essential amino acids , fat (mostly unsaturated fatty acids and no cholesterol). Historically developed for people with lactose intolerance or allergy to proteins of cows , food and drink soy were also recommended for people with high cholesterol.

The role of soy in the prevention of various diseases, especially cancer, is limited and uncertain , according to the findings of a U.S. government report , reported in an article published in the "Journal of the National Cancer Institute " ( JNCI ) .
Soy and Health: bad or not ?
" A government report concluded that the evidence of benefit of soy in the prevention of various diseases including cancer , was uncertain and limited , despite numerous studies have focused on the topic ," said Damaris Christensen, in the journal JNCI .

* The government report , funded by the U.S. Agency for Health Research and Quality ( Agency for Healthcare Research and Quality , AHRQ) , analyzed 178 previous studies focused on soy foods , soy milk and food supplements including soy isoflavone extracts . The researchers studied the effects of soy on various diseases and functions of the body : cancer , kidney disease , cardiovascular disease , endocrine function , reproduction, bone metabolism etc. .

The authors have shown that consumption of soy protein provides small benefits in terms of reducing the risk of heart disease by reducing low-density lipoprotein (LDL) or "bad cholesterol" . In addition , isoflavones found in soy reduce the frequency of hot flashes during menopause. On other diseases , including cancer, no result is proved successful , because " a small number of studies, poor quality and they are too short ," said a press summary of the report the AHRQ .

Several clinical studies have examined , in people with no history of cancer, the effects of soy consumption on the level of biomarkers associated with cancer : expression of receptors for estrogen and progesterone, prolactin concentration , PSA level and cortisol .

No significant effect of soy in cancer prevention
But none of these biomarkers have been clearly associated with a risk of cancer, " no study has been able to provide significant evidence of a beneficial effect of soy in the prevention of cancer ," said the author of the study , Ethan Balk , New England Medical Center in Boston ( USA) .

Conducting more rigorous studies nevertheless seems difficult due to the low number of validated biomarkers for cancer, the time required for development of the disease and the difficulty associated with the call participants a special diet over a long period .

" Experimental studies in vitro and population studies have shown an association between soy and a reduced risk of cancer," recalled Karen Collins , however , a nutritionist at the American Institute for Cancer Research in Washington.

So many epidemiological studies have suggested that high consumers of soy have a lower risk of breast , colon , endometrial and prostate cancer compared with the general population.

However, the scientists hope that further studies will better define the role of soy in preventing and treating cancer .