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 .

Jean- Claude Pechère , president of the International Society of chemotherapy and corresponding member of National Academy of Medicine , presented the results of a European survey showing that the perception of the physician by the patient affects the attitude of the last in terms of consumption of antibiotics
survey
The survey was presented at the press conference in the preamble of the thematic session of the National Academy of Medicine devoted to proper use of antibiotics .

Conducted in 2002 in four European countries (Germany, Spain, Italy, France ) , the survey was conducted with the support of a UK survey, which has participated in the development of 120 questions that participants had to answer . In each country were interviewed 600 adults who were faced with a mild respiratory infection treated with antibiotics in the two months preceding the survey , and 200 persons responsible for a child aged 18 months to 12 years who have experienced the same position .

Analysis of the responses to the questionnaire ( on the socio -demographic characteristics of the subject, the condition being treated , and the perception of the attitude of their doctor ) has identified four categories of patients , depending on their attitude à-vis their relationship with their physician , said Jean -Claude Pechère .

Four profiles - type patients
First category of patients identified through this study: "involved sick." Slightly older than the other patients , they actively participate in their own care, particularly regarding decisions about their health. According to the records of the survey , 30% of Europeans surveyed fall under this scheme, which is more common in Germany (43% of respondents , against 31% in France ) .

The " vas sick " consider for their physician as an expert and " comply with its requirements ," added Jean- Claude Pechère . A little older than the average, they represent nearly a quarter of respondents ( 23%) and are more common in France (34%) and Spain ( 32%).

In terms of consumption of antibiotics , these first two categories together "good patients who do not have bad habits ," noted Jean- Claude Pechère , while the following two frequently exhibit behaviors.

Thus, the " ignored sick " does not have good contact with their doctor which they assume it does not listen or do not believe (13 % on average , 44 % in Italy and 12% in France ) while " critically ill " , which are characterized by a level higher than the average participant education, doubt his skills. They are particularly numerous in France (35%) and Italy ( 34%).

The evaluation of the behavior of these different types of patient in terms of consumption of antibiotics has emphasized that these are two categories who know the least about the rules for the proper use of antibiotics. Indeed, the " unknown " and "critical" are significantly less likely to show good adherence to treatment .

But quitting treatment before the end or not to comply with the number of shots daily - even if symptoms disappear will provide bacteria conditions " ideal to become resistant ," said Didier Pittet, prevention service and infection control at the University Hospitals of Geneva ( Switzerland). Indeed , the decrease in blood concentrations of antibiotics derived from this approach eliminates sensitive bacteria without affecting the resistant bacteria , which then proliferate freely.

In addition , 80% of " ignored " acceptable to keep an antibiotic not used for later use , attitude criticized by specialists present. Indeed, this habit of self-prescription later is often the cause of an unjustified use of antibiotics ( for colds, sore throat , cough, or viral infection) that participates in the development of resistance .

Another disturbing fact: whatever the group of patients seen , almost eight out of ten people believe that flu (viral illness) should be treated with antibiotics ( products intended to fight against bacteria ) .

Antibiotics ... less automatic
Patrick Choutet , the infectious diseases hospital Bretonneau CHU Tours ( Indre-et- Loire), however, pointed out that France , the information campaign since 2002 with the slogan " antibiotics, c ' is not automatic " helped rectify .

Indeed, the repetition of this information and awareness campaign about the risks of overuse of antibiotics has reduced antibiotic prescriptions by 11.4% during the winter of 2002-2003 compared to the previous year , and a further reduction of 5.4 % between the 2002-2003 season and the next.

The polls also showed an improvement in the knowledge of the general public on antibiotics, confirming the effectiveness of the campaign.

However, this tends to reduce the use of antibiotics to keep this campaign "should be relayed by the doctors ," said Jean- Claude Pechère . Based on the results of the European he was the instigator study, he insisted that doctors , identifying profiles of patients may try to improve their relationship by involving patients falling risk categories of misuse of antibiotics.

The practitioner " can go from worst to best regarding the use of antibiotics , namely the category of ignored that involved," he summarized .

Once limited to some variety of products and of poor nutritional quality, snacking today for a wide range of foods and more responsive to the demand for quality and diversity of the consumer.
Suitable for a quick lunch break
The term " snacking " is generally considered any product that does not require consumer table. It can be taken as well outside of regular meals or replace .

Apart from the timeless sandwich (base all snackers ) , the flagship products are dairy products (38%) , salty snack foods (15 %) and pastries (11%) and some salad bars cereals, soups, pies and sweet and ethnic specialties (tapas , spring rolls ) .

In 2005, 60 % of workers employed in a municipality other than their place of residence. The lunch break is spent in five years 1:22 to 38 minutes. This explains the popularity of this new mode of consumption . France has also become the third largest European consumer snacking , behind Germany and yet far enough from Britain which consumes 2.5 times more than us.

Some illustrative figures for France :
- 9.1 kg of snacking products consumed per capita per year
- 1.5 million sandwiches consumed each day
- 75 % of Parisians eat a sandwich at lunchtime .

The main focus of development lies in a balanced diet and light products : 42% of consumers believe that eating is an act of health. However, the French are very traditional : 60% of sandwiches are made ​​from traditional baguette .

A tendency to integrate into the supply
Previously associated with a sense of total imbalance of calories and nutrients , today's snacks have adapted to the latest official nutritional recommendations.

It is the arrival of snacking "intelligent" , which falls more often in the context of a balanced meal . Thus we find different breads (complete , sesame, polar ) and food composition ( crayfish , smoked salmon ), which allow these " improved snacks " to be called " nutritionally correct " by health professionals .

Snacks to avoid are those composed of a fatty food ( meat , fatty meat , fried ) , associated with an excessive amount of sauce and a sweet soda.

New habits of French are therefore in a strong tendency to " snacking " . Indeed, it is one of four meals in the workplace , one of three in the leisure and 1 of 2 in travel. Moreover , the phenomenon extends to all times of the day and joins the new culinary trends such as brunch, dinner aperitif , or foreign flavors.

Radiotherapy offers an overall better quality of life to 5 years in men treated for prostate cancer , compared with radical prostatectomy , according to a study whose results were presented in the "Journal of the National Cancer Institute ."
Radical prostatectomy has shown that it can reduce disease -specific mortality compared to a simple oversight , but a large clinical trial showed that the treatment had significant adverse effects on sexual and urinary function and that n ' not improved overall survival. Radiotherapy , another option is associated with fewer complications . But there are few long-term comparative data.

The Arnold L. team Potosky , National Cancer Institute, has sought to assess the long -term quality of life related to the health of patients treated according to the treatment modality that was offered to them . For this, they followed more than 1,000 men diagnosed with localized prostate cancer , treated with either radiotherapy or radical prostatectomy .

From their testimonies , they compared the state of their urinary , bowel and sexual function before treatment, two years after diagnosis and 5 years after diagnosis .

At follow-up , it appears that overall sexual function , interest rate, ability to perform the sexual act - declined substantially similar in both groups. However , erectile dysfunction was more common in the surgery group (79.3% against 63.5%) .

In addition, more patients treated with prostatectomy were faced with problems of urinary incontinence , compared with patients treated with radiotherapy (15.3% against 4.1%). In contrast , men treated with radiation suffered more diarrhea (29%) and painful hemorrhoids (20 % ) compared to patients treated with radical prostatectomy (19% and 10%) .

" Five years after diagnosis, men treated with prostatectomy continue to suffer more urinary incontinence than those treated with radiotherapy . However , both treatments are joined on impotence, primarily due to a continued decline in function erectile dysfunction in patients treated with radiation therapy , " the authors summarize .

Despite the presence of cancer more aggressive prostate cancer in obese patients, the survival rate after surgical treatment was similar in obese and other patients , according to a study published in the journal "Cancer" .
The role of obesity in the development and response of prostate cancer treatment is not clear . Some studies have shown that obese patients had an increased risk of recurrence after surgical removal of the prostate ( prostatectomy) compared with normal-weight men risk.

Sameer Siddiqui from the Mayo Clinic in Rochester (USA ) and colleagues conducted a study of 5,313 patients who underwent radical prostatectomy between 1990 and 1999 to assess the impact of obesity on the clinical course of prostate cancer and the long-term survival . The median follow-up of patients was 10 years.

The patients were divided into three groups according to their body size defined by the value of the body mass index (BMI , weight ratio of the square of height ) . A BMI <25 corresponds to a normal weight , a BMI between 25 and 29.9 to be overweight and a BMI > 30 with obesity .

The clinical and pathological aspects of prostate cancer proved worse in obese patients than in other patients. However, after surgery , obesity has caused no impact on biochemical progression ( rate of prostate antigen , PSA ) and systemic cancer or the recurrence-free survival nor overall survival.

Despite prostate cancers tend to be more aggressive at the start, the long-term survival after surgical treatment appears identical in obese patients and in non-obese patients , the authors conclude.

The period between 6 and 18 months after initiation of anti-HIV treatment is a good prognostic factor for the patient's condition over several years, according to a study published in " Clinical Infectious Diseases" .
Several studies have already examined the predictive value of virologic response during the first six months of highly active antiretroviral therapy (HAART). But Nicolai Lohse , University Hospital of Odense (Denmark), and his colleagues believe that the prognostic nature of this period, often punctuated by episodes of toxicity and changes in antiretroviral regimen is limited.

The researchers conducted a study of 2046 Danish patients to determine if recorded during the period between six months and 18 months after initiation of HAART viral load possible to better predict the patient's condition after 90 months of treatment .

They divided the patients into three groups according to viral load measurements recorded during the period of one year .

The first group consisted of 1173 patients with persistently undetectable viral load ( below 400 copies / ml) during the year , while that of the 327 patients in group 3 had never been below the detection limit. Group 2 included 546 patients having the other two types of results .

After 90 months of treatment, almost all patients in the first group (96%) had an undetectable viral load , against 83% in group 2 and 57% in group 3.

Compared with patients in the first group (92.7 % of survivors) , group 2 were 2.63 times more likely to die , while those in Group 3 endured a risk multiplied by 4.53 . The latter died more frequently following a progression to AIDS disease (43%) than group 1 ( 18%).

In the end, 89% of patients in group 1 were still alive and had an undetectable viral load after 90 months of treatment, against 71% in group 2 and 43% in group 3.

The researchers also highlighted the negative effect of treatment interruptions . The 92 patients in group 2 having stopped at least two weeks during the first 18 months had a chance of survival 3.48 times lower than that of people more observant of the same group , and even 1.49 times lower than that of patients group 3 .

" A therapeutic abortion during the first 18 months of HAART is a good predictor of mortality in patients who achieve a partial viral suppression ," said the authors .

" The achievement of an undetectable viral load is the primary goal of treatment in routine clinical practice," they concluded .

While fashion omega -3 invades the windows of bookstores and multiplies until indigestion references to their virtues on FMCG finally have a reference book on these essential fatty acids in our diet .
Simply titled " The Truth About Omega- 3" , this book is the work of one of the discoverers of the effects of these fats on the brain. This is Dr. Jean -Marie Bourre who led a research unit INSERM specialized in brain chemistry and its relationship to nutrition.

Famous for having published " Dietary brain : the new deal " or "Food intelligence ", " The diet of the performance," Jean -Marie Bourre try to give appropriate answers to many questions raised by the fashion omega-3. Are they really essential to our health ? What is their effect on our moods , their effect on libido and psychological disorders ? Is it really demonstrated to reduce the cardiovascular risk , reduce hypertension , moderate inflammation?

Jean -Marie Bourre appropriates the discourse of omega -3 while another physician, Dr. David Servan- Schreiber, surfs the expectations of customers in need of well-being to popularize these fats to make his book ( "Healing " ) a runaway bestseller ( at least 400,000 copies sold) .

The chance of Jean -Marie Bourre was discovered omega-3 in the study of fundamental stage of life : the development of the brain. His initial observation was that breast milk is very rich, the brain also . His work then quickly demonstrated that omega -3 conditioned visual and cerebral abilities, including intellectual .

The head of the omega-3 family is denominated alpha -linolenic acid ( ALA) . It is mainly found in canola oil and nuts.

"Every French daily consumes about 15 grams of vegetable oil , which is the size of a soup spoon and a half : we must continue to focus on everything but the price of rapeseed oil , which is more inexpensive ," he concludes .

With regard to other families of omega- 3 (EPA , DHA) , they are in the wild fatty fish and livestock provided that their food was satisfactory, as the variability of the nutritional value of fish large by farming methods . For meat and dairy products , the researcher focuses on livestock products using linseed ( still rare ) method .

Wanting to practice , the researcher will select up to fish according to their cost per unit of omega -3 . We discover and mackerel - much maligned , is well placed , well ahead of the sole and monkfish .

Annexes to the book also help to navigate the jungle of definitions at the base of the food while another book also tries to explain the virtues of these fats.

Entitled "The omega -3 diet, the food program to save our health," this book became an international bestseller ( 1 million copies ) is both theoretical and practical. It proposes austere non - revenue - that will give cooks the sense of acting directly on their health.

The two American authors ( Dr. Artemis Simopoulos , Jo Robinson) were joined Dr. Michel de Lorgeril cardiologist and nutritionist, France proponent of the Mediterranean diet , and Patricia Salen currently contributing to the European study " IMMIDIET " .

Fashion omega -3 is omnipresent. Consume with caution.

* The Truth About Omega-3 , Jean -Marie Bourre, Ed Odile Jacob , 278p , 21.90 euros
* Healing , David Servan- Schreiber, Ed Robert Laffont, 300p , 20 euros
* The omega -3 diet , Artemis Simopoulos and Jo Robinson , Michel de Lorgeril and Patricia Salen , Ed Grenoble Sciences , 374p , 20 euros

Sudden infant death is still about 350 people each year in France , while simple preventive measures such as baby sleeping on the back would halve the mortality associated with this syndrome whose psychological impact on the family dramatic .
Sudden infant death syndrome is a multifactorial accident , the first contributing factor is the alteration of the maturation control vital functions leading to immaturity of respiratory, cardiac , and autonomic arousal mechanisms , said Dr Anne France - Bongrand , pediatrician reference Centre of sudden infant death (SIDS) in Montpellier, at a conference organized in the framework of interviews Bichat in Paris.

The second factor is the existence of a state intercurrent disease such as lightning (bacterial or viral infection ), heart disease and , more rarely , metabolic diseases characterized by an energy deficit in children. Gastroesophageal reflux may also increase the risk of SIDS , but it is not enough by itself to cause the accident , said the pediatrician.

" There are only a few ways of action on these two factors ."

However, there are in the middle of the child to know the sleeping conditions , ambient temperature , passive smoking ... Information campaigns are also based on these risk factors and how to avoid them. The first was launched in 1994 with the message "I sleep on the back ."

It had the effect of greatly contribute to the reduction in the incidence of SIDS , however regression knows a plateau for several years while we have regrets about one death per day due to this type of accident .

" It has stagnated , confirmed Dr. Elisabeth Briand - Huchet, pediatrician CNRMSN Clamart ( Hauts-de- Seine ) . And the forecast for the next three years show that we will stay in the same numbers." Yet , says the doctor , " even half of MSN is due to sleeping at risk ."

And include basic tips to minimize the risk of sudden infant death syndrome : the baby should sleep on his back, on a bed of security to size. Pillows and duvets are not recommended , but if the ambient temperature of the room is cool (18-20 ° C is recommended) , it is advisable to dress in a sleeping bag .

According to statistics, the ventral multiplies by 13 the risk of SIDS . On the belly, the baby can move and be faced with the risk of landfill hyperthermia it is less easy fight , especially at major risk containment whose consequence is hypoxia and hypercapnia ( excessive amount of carbonic acid in the blood) quickly dangerous .

However, the pediatrician recommend playing the baby on his stomach to make him move his arms in front and rely on it to get up, he can use reflex rollover in bed. Other advice recently emerged, that of not sharing the bed with her baby , attitude called " co- sleeping" by the Americans, which multiplies by 16 the risk of SIDS .

Those about to undergo surgery by a young surgeon can reassure the risk they die after the operation is not proportional to the number of years of physician practice which operates the results indicate a study published on the website of the " British Medical Journal "
The British team of researchers led by Ben Bridgewater, of the University Hospital of Manchester, analyzed the records of nearly 19,000 patients who underwent their first coronary surgery between April 1997 and March 2003, hospitals in the North West England. For more than 5,600 of them , the intervention was performed by a surgeon in office for less than four years.

They analyzed the operative mortality of different surgeons based on their experience: during the first year following their appointment, and for each of three years, and these results were compared with those observed for the most experienced surgeons.

The overall mortality rate (observed mortality and predicted mortality before surgery ) in this study was 2 % , and did not present significant differences by the surgeon who performed the procedure was tested (2%) or was in his first four years in office (1.9 %).

However , there is still a gradual reduction in mortality during the first year after the appointment , the authors note.

It goes from 2.2% for the first year to 1.2% for the fourth , and this trend persisted after adjustment results.

The expected mortality following for its reverse trend , with an increase during the first four years of practice , suggesting that surgeons operate on patients with diseases increasingly complex .

These findings suggest that the application of the European Directive 93/ 104 on the working time should exert a negative impact on the experience of young surgeons and the evolution of the " learning curve ," say the authors .

Applicable in France since 1 January 2003, the directive requires in particular to limit working time to 48 hours per week , including guards , and establish a daily rest period of 11 hours per 24 hour period .

Children who received multiple vaccines are not exposed to a greater risk of hospitalization for infectious disease untargeted by vaccination , provide Danish researchers in the "Journal of the American Medical Association ."
Over the past two decades , access to vaccines developed and the vaccination schedule of small has become extremely complex , causing concern among some who fear that the multiplication of vaccine injections or administration of multivalent vaccines ( such that MMR ) cause dysfunction of the immune system , resulting in the development of non-target infectious disease .

In 2002, a meta-analysis conducted by the U.S. Institute of Medicine concluded that the existence of biological mechanisms by which multiple vaccinations could influence the risk of non-target infectious diseases. Clinical and epidemiological evidence for such an effect are yet lacking , some studies have even shown a beneficial effect otherwise .

To shed light on the link between multiple vaccines administered during childhood (DTP , MMR , pertussis, Hib , ...) and the risk of hospitalization for a non-targeted infection, Anders Hviid and colleagues at the Statens Serum Institut in Copenhagen examined data from a population-based study between 1990 and 2001 to 805,206 children.

In particular, they examined the information on the types and number of vaccine doses , hospitalizations for infections, including those affecting the upper respiratory tract , viral and bacterial pneumonia , septicemia , infections of the central nervous system , meningitis and bacterial diarrhea.

Of the 42 possible combinations (6 vaccines and 7 categories of infectious diseases) , only the one between the Hib vaccine and acute upper respiratory tract infection resulted in side effects.

" Conversely , the 15 observed protective associations suggest that vaccination may be protective of non-target effects. [ ... ] In conclusion, our results do not support the hypothesis of an increased risk of infections after non-target risk injection of childhood vaccines, " the authors conclude.

Intense sexual activity between 20 and 40 years may increase the risk of developing prostate cancer , according to a British study , contrary to previous work , which had reached a rather protective effect.
In France , as in most Western countries , the most common cancer in men is the prostate , with 62,245 new cases in 2005 and an average age at diagnosis beyond 70 years.

In 2003-2004 , some studies * had examined the influence of sexual factors, including masturbation and ejaculation more generally , on the risk of developing prostate cancer . The researchers then struggled to find a significant relationship between the two , and when there was one , it was rather in favor of a beneficial effect of frequent sexual practice effect.

But the mischievous idea of ​​" take charge of their health " to prevent prostate cancer could be undermined by a British study published in the journal British Journal of Urology ( BJU ) . Dr. Polyxeni Dimitropoulou and colleagues at the University of Nottingham (United Kingdom ) have shown that intense sexual activity between 20 and 40 years may be linked to greater risk of subsequently developing a prostate cancer .

Most of the work that examined the risk of this type of cancer based on sexual activity focused on the study of older men. "We wanted to analyze the link between sexual activity and younger men ," say British researchers .

They then compared the sexual practices of 431 men who developed prostate cancer diagnosed before age 60 with those of 409 men free of cancer and served as controls . Everyone had to complete a questionnaire about their sexual habits , frequency of sexual intercourse , masturbation , sexual activity globally , detailed from the age of 20 and by 10 years.

Their results show that the overall sexual activity ( masturbation reports + ) in the twenty years increases the risk of prostate cancer , while it seems protective after 50 years.

Thus, 40% of men who developed prostate cancer among those who reported the most intense sexual activity between 20-30 years (20 or more times per month), against only 32% of controls . The same types of patterns were observed between 30-40 years and 40-50 years.

Similarly , frequent masturbation is associated with an increased risk of cancer when performed between 20 and 40 years. For example, between 20-30 years , masturbate two to seven times per week increases the risk by about 80 % compared to less than once per month. And masturbate once a week or more between 30-40 years increases the risk of near de70 %.

However , masturbation has a protective effect between 50-60 years as this practice once or more per week reduces the risk of cancer by 70%.

Moreover, considered alone , the frequency of sex has no impact on the risk of developing this cancer.

In an attempt to explain the link between sexual activity and prostate cancer , researchers quickly evoke a hormonal involvement : " hormones seem to play a key role in prostate cancer (...) The sexual behavior of a man is also regulated by his hormone " rate .

" One possible explanation for the protective effect that 50-60 years seem withdraw their overall sexual activity, and particularly masturbation, is that the release during sexual activity, accumulated toxins reduces the risk of developing cancer in the prostate area , "also suggest the researchers.

According to an article in New Scientist , masturbation in particular limit the accumulation of seminal fluid component of semen. However, some compounds of this fluid (potassium, zinc , fructose, citric acid and 3- methylcholanthrene for smokers ) may have carcinogenic properties in case of stagnation in the prostatic ducts , where the interest of the " release " regular .

Antiretroviral cause premature aging of cells, according to results presented at a meeting on lipodystrophy , organized by the National Agency for Research on AIDS and Viral Hepatitis ( ANRS) .
Several studies have described the role of the two main classes of antiretroviral drugs , protease inhibitors (PI) and nucleoside reverse transcriptase inhibitors (NRTIs ) in the mitochondrial toxicity observed in patients infected with the AIDS virus (HIV), which one of the main symptoms is the appearance of lipodystrophy ( defects distribution of lipids ) .

The team of Dr. Jacqueline Capeau , Faculty of Medicine Saint- Antoine in Paris , showed a cellular aging due to antiretrovirals. These results were presented at a meeting organized by the Coordinated Action 22 , the working group dedicated to HIV-associated lipodystrophy , the ANRS .

Although mitochondrial toxicity of antiretrovirals is proven for several years, this work establishes a link between cellular aging and antiretrovirals are a first , according to Dr. Capeau .

The researchers treated mouse cells of adipocyte lineage with multiple antiretroviral agents.

Among five molecules , only one did not result in more signs of cellular aging than placebo.

The other four molecules generated several telltale signs of premature senescence . Researchers have particularly noted a decrease cell proliferation they attributed to the overexpression of several proteins involved in cell cycle arrest , such as p21 and p16 proteins.

Confirming several previous results, INTI result in a loss of synthesis of mitochondrial DNA , known also as a symptom of cellular aging. This alteration is due to the inhibitory action , already described, of NRTIs on DNA polymerase gamma , the enzyme responsible for the replication of the mitochondrial genome.

Treating the cells with the result of defects IP maturation of lamin A, a protein involved in the structure of the nuclear wall . Resulting in an accumulation of pre- lamin A precursor , this anomaly is present in several lipodystrophy but also among people with progeria , a rare form of premature aging of genetic origin.

These two phenomena , laminopathy observed with IP and mitochondrial toxicity of NRTIs, were , according to the researchers responsible for the intracellular production of free radicals they observed . These chemical variations, highly oxidizing , are involved in aging and cellular stress.

Dr. Jacqueline Capeau told Reuters Health that the idea of this research was born as a result of testimony from numerous patients on therapy that express fatigue and " feeling older " .

People who have survived cancer admired in the United States , where they are named the ' survivors ' . An article on the lessons learned to listen to them to return the offset to the situation in France , where the cancer is still dragging the image of a " shameful " disease.
' Survivors ', ' cancer warrior ', ' veteran ' ...
In the United States there are 12 million ' survivors ', including 14 % who developed the disease at least 20 years ago . A field of research has emerged in response to the needs of clinicians, survivors, politicians and the public to better understand the concerns of this growing population , said Dr. Julia Rowland, National Cancer Institute, Bethesda ( Maryland ) .

In an article published in the journal Cancer , it highlights the lessons learned from these studies. Several key points discussed were positively enjoyed these patients or overseas ex- sick picture.

The researcher stresses eg the determination of ' survivors ': " The remarkable resilience of the survivors cope with the many demands of cancer is probably the biggest lesson learned humility from the study of survivors. "

" Cancer survivors may feel pride , not just relief, in their ability to endure the treatments," she expresses .

It also emphasizes the importance of language. How to raise cancer has a " significant impact on the meaning given to the disease and the forces then taken to combat it ." The ' survivors ' have the ability to think differently because they can use words that best define as ' cancer warrior ' or ' veteran ' says Julia Rowland .

No " survivors " of cancer in France
Despite a rather combative language we speak of " fight " against cancer , there is no " survivors " of cancer in France but " people who have had cancer ," a paraphrase of reflecting the ' deficit image of this population.

The campaign launched by the National Cancer Institute ( Inca ) on " 2,000,000 ordinary hero " , the French who are or have been directly confronted with cancer, to change the look of the public has not erased the offset on both sides of the Atlantic .

In the United States , the cultural pattern is different, explains APM Anne Ramon , director of public information to the Inca . " It is striking to go see the hub of private initiatives. There is a strong mobilization of civil society , which is active in communities and associations of self-support ."

" The psychological care of people with or have been affected by cancer occurs more through actions, such as discussion groups , and less professional ," she says .

The organizations have a strong in lobbying and are able to mobilize volunteers spread throughout the country. They have developed tools to help people to get involved in a combative attitude.

" It is in combat concepts and influence while in France , the concepts put forward are suffering and difficulties," says Anne Ramon .

The unique combination of death tends to distend
At the same time , the official said the French paradox " a treatable getting better but that keeps the image of a disease we die . "

" The social representation evolves more slowly than medical advances ," she analysis , noting that more than 60% of French people believe that cancer is the most serious disease ( Inca / Ipsos , 2007).

Anne Ramon advanced a " rather irrational " avoidance on the part of people who have not been directly confronted behavior. A third of the population is able to agree with the opinion that " cancer, the less you hear , you will feel better " ( League / Ifop , 2008).

As a result of this taboo , " the voice of patients is difficult to hear , which continues the tradition of a shameful disease that tends to silence . (...) There is a real difference between public good health and feeling sick or former patients who feel they work in a slightly parallel universe . "

However, the exclusive association of death tends to stretch on the pulse of the medical advances . The perception of a social stigma or relegation is no longer in the majority opinion , tempers Anne Ramon .

Thus , 89 % of the population believes that talking about cancer is no longer taboo ( INPE , 2005). "Despite the persistent gap , things are moving ," is she pleased .

" We are currently in -between, between the old image of the disease , severe , often fatal , and the hopes raised by research progress and the realization of a heterogeneous disease with prognosis and different treatments . "

The first convention of the society with cancer , which led to a "big mobilization " , showed that the situation was much changing , " thanks to the cancer plan and always to medical advances ," said Anne Ramon .

Men suffering from prostate cancer early stage who decide to change radically their diet and lifestyle are likely to see it stop or even reverse the course of their disease , researchers report in the " Journal of Urology "
First of a series of trials attempting to better identify the exact role of diet and lifestyle in the prevention and treatment of prostate cancer , this study was directed by Dean Ornish and Peter Carroll in the University of California at San Francisco, in collaboration with William Fair , head of the urology department and president of the Chair of urologic Oncology at Memorial Sloan -Kettering Cancer Center.

It focuses on 93 men with prostate cancer confirmed by biopsy , who decided , for reasons of their own , not to follow conventional treatment . Half of the participants were instructed to radically change their diet and lifestyle, while the other half received no specific recommendation.

After one year, the researchers observed a significant decrease (-4 %) of PSA in men who have changed their lifestyle , while he is high ( 6 %) in other . There was a direct correlation between the degree of change in the lifestyle and the PSA .

In addition, in vitro tests showed that the serum of participants in the first group 70% inhibited the growth of prostate tumor , against only 9% of men in the control group . Once again, the importance of this effect was perfectly correlated with the degree of change in lifestyle.

As in coronary disease , radical food and lifestyle changes can therefore help reverse the trend of early prostate cancer and little progress , the researchers conclude.