The traumatic memory, a consequence of the psychotrauma induced by incestuous violence, has inhabited Delphine throughout her childhood and a large part of her adult life. At the age of 40, following the revelations of her sister, she began psychotherapy and identified the traumatic events. She is finally able to understand and link a plural somatic symptomatology to a post-traumatic syndrome... Delphine shares here the story of this traumatic memory.

In the practice of carpal tunnel surgery, open decompression of the median nerve in carpal tunnel syndrome (CTS) is recognized as the therapeutic priority. However, the speed and completeness of postoperative recovery of sensitivity and function depend on the initial clinical manifestations of the disease and the severity of the electrophysiological disorder. The aim of this study was to investigate the influence of preoperative clinical and electrophysiological factors on the outcome of surgical treatment of patients with CTS of varying severity. One-hundred and eighty-nine open decompressions of the median nerve via a mini-open incision were performed in 161 patients with idiopathic CTS. Clinical observations were classified in 5 groups, according to severity. Treatment results were evaluated per group at 6 weeks and 3, 6 and 12 months after surgery. In all cases, there was improvement and positive dynamics according to clinical and electroneuromyographic data. Open decompression of the median nerve via mini-open incision can achieve significant clinical and functional improvement in the majority of patients with CTS. However, the most favorable results were mainly seen in patients with initial severity classified in the first, second and third (lower severity) groups.

We estimated the incidence of COVID-19-compatible symptoms, COVID-19 testing, and GP consultations during the first lockdown period in Switzerland (March-April 2020). A representative sample of the adult Swiss population completed an online survey. Of the 1022 respondents, 74 % reported at least one symptom, 5 % were tested for COVID-19, and 8 % contacted their GP regarding COVID-19. Testing was significantly associated with reduced sense of taste/smell, fever, cough with expectoration, and fatigue. Respondents at risk for severe COVID-19 were less likely to be tested but were five times more likely to contact their GP than those not at risk. We highlight the need to involve the appropriate health care setting to reach the vulnerable population when testing capacities are restricted (e.g. GPs).

Adenomyosis is a chronic benign uterine disease characterized by the presence of endometrial glands and stroma within the myometrium. It is a heterogeneous disease, presenting various clinical forms, depending on the location of the ectopic lesions within the myometrium. Adenomyosis can be responsible for several symptoms such as dysmenorrhea, abnormal uterine bleeding and/or infertility. Its pathophysiology is a real conundrum and several theories have been proposed: development of adenomyosis lesion could initiate de novo from Mullerian rests or from stem cells. Moreover, multiple factors could be involved in initiating lesions, including specific hormonal, immune and/or genetic changes. The objective of this review is to provide an update on adenomyosis pathophysiology, in particular on the various theories proposed concerning the invasion of the myometrium by endometrial cells and the inducing mechanisms, and to study the link between the physiopathology, the symptoms and the medical treatments.

UNASSIGNED: Concussion is a common injury in an adolescent population with up to 30% experiencing persistent symptoms. Rehabilitation programs that include aerobic exercises can reduce persistent postconcussion symptoms. However, it is unclear if daily life physical activities can also reduce symptoms.
UNASSIGNED: To investigate whether the level of daily life physical activity reduces postconcussion symptoms in the adolescent population.
UNASSIGNED: Ten adolescents aged 11-18 years with a concussion self-reported their postconcussion symptoms and level of physical activity during the first, third, and sixth months after injury. The extent to which physical activity explained postconcussion health was analyzed using linear mixed-effects modeling.
UNASSIGNED: Higher levels of daily life physical activity were associated with fewer somatic and cognitive symptoms.
UNASSIGNED: These findings suggest that daily life physical activity, including engagement in sports, physical education, or active games, should be encouraged by occupational therapists to promote concussion recovery.

To determine clinical correlates of the peripheral absolute eosinophil count (AEC) among bacteriologically confirmed TB patients in Uganda.
We evaluated data of bacteriologically confirmed adult TB patients who had a peripheral blood AEC measurement at the National TB Treatment Center in Uganda during a cross-sectional study. We performed linear regression analysis for correlates of log-transformed AEC.
We included 235 patients in this analysis with a median (interquartile range, IQR) age of 31 (24-39) years. 60.4% were male, and 33.6% had TB/HIV co-infection. In a multivariable linear regression model that controlled for age, residence type, HIV status, weight loss, anorexia, body mass index, CD8+ T-cell count, haemoglobin level and TB bacillary load, males had a 47.0% higher AEC than females (adjusted coefficient (R2 ) = 0.385, 95% confidence interval (CI) 0.012-0.759 P = 0.043). Also, a 1 °C raise in temperature resulted in an 11.5% decrease in the AEC (R2  = -0.122 95% CI (-0.233 to -0.011) P = 0.031) while a 1 cell/mm3 increase in the CD4+ T-cell count resulted in a 0.10% increase in the AEC (R2  = 0.001 95% CI (0.000-0.001) P = 0.032).
The AEC was higher among males than females, consistent with the normal population distribution of AEC among Ugandans. The AEC was weakly but positively correlated with the CD4 count and negatively correlated with temperature.
Déterminer les corrélats cliniques du nombre absolu d\'éosinophiles (AEC) périphériques chez les patients tuberculeux confirmés bactériologiquement en Ouganda. MATÉRIEL ET MÉTHODES: Nous avons évalué les données des patients adultes atteints de tuberculose (TB) confirmés bactériologiquement qui avaient une mesure de l\'AEC du sang périphérique au Centre national de traitement de la TB en Ouganda au cours d\'une étude transversale. Nous avons effectué une analyse de régression linéaire pour les corrélats de l\'AEC convertis en log. RÉSULTATS: Nous avons inclus 235 patients dans cette analyse avec un âge médian (intervalle interquartile, IQR) de 31 (24-39) ans. 60,4% étaient des hommes et 33,6% avaient une coinfection TB/VIH. Dans un modèle de régression linéaire multivariée qui adustait pour l\'âge, le type de résidence, le statut VIH, la perte de poids, l\'anorexie, l\'indice de masse corporelle, le nombre de lymphocytes T CD8+, le taux d\'hémoglobine et la charge bacillaire de TB, les hommes avaient un AEC 47,0% plus élevé que les femmes (ajusté (R2 ) = 0,385, intervalle de confiance (IC) à 95%: 0,012 à 0,759 ; P = 0,043). Aussi, une augmentation de 1 °C de la température a entraîné une diminution de 11,5% de l\'AEC (R2 = −0,122 ; IC95%: (−0,233 à −0,011) ; P = 0,031) tandis qu\'une augmentation de 1 cellule/mm3 du nombre des cellules T CD4+ a entraîné une augmentation de 0,10% de l\'AEC (R2 = 0,001 ; IC95% (0,000 à 0,001) ; P = 0,032).
L’AEC était plus élevé chez les hommes que chez les femmes, ce qui correspond à la répartition normale de la population de l’AEC chez les Ougandais. L\'AEC était faiblement mais positivement corrélée avec le nombre de CD4 et négativement corrélée avec la température.

Caring for people with chronic pain is complex and multifaceted. At the Rothschild Hospital in Paris, the multi-professional team of the pain assessment and treatment service includes a music therapist. On medical orientation and according to the typology of the source pathology, this professional opens to the patients spaces of musical relaxation and awareness that a better well-being is possible.

Programs for neglected tropical diseases (NTDs) such as sleeping sickness increasingly involve patients and community workers in syndromic case detection with little exploration of patient understandings of symptoms. Drawing on concepts from sensorial anthropology, I investigate peoples\' experiences of sleeping sickness in South Sudan. People here sense the disease through discourses about four symptoms (pain, sleepiness, confusion and hunger) using biomedical and ethnophysiological concepts and sensations of risk in the post-conflict environment. When identified together, the symptoms interlock as a complete disease, prompting people to seek hospital-based care. Such local forms of sense-making enable diagnosis and help control programs function.

ABSTRACTExercise has potential to mitigate morbidity in knee osteoarthritis (OA). Participants with knee OA were randomized to a Square-stepping Exercise (SSE) group (2x/week for 24 weeks) or a control group. We assessed the feasibility of SSE and its effectiveness on symptoms (WOMAC), balance (Fullerton), mobility, and walking speed at 12 and 24 weeks. The SSE group had a 49.3% attendance rate and trended toward improvement in the 30-second chair stand at 12 (F = 1.8, p = .12, ηp2 = 0.16), and 24 weeks, (F = 3.4, p = .09, ηp2 = 0.18), and walking speed at 24 weeks, compared to controls. There were no differences in symptoms or balance. The low attendance and recruitment demonstrated limited feasibility of SSE in adults with knee OA. Trends suggest the potential for SSE to improve lower extremity functional fitness and walking speed. SSE should be further studied for effectiveness on symptoms and balance, in addition to improving feasibility.

Schizophrenia is a severe chronic mental disorder that mainly manifests by positive symptoms, negative symptoms, disorganized behavior and thought and cognitive impairments. Taken together, these symptoms have substantial impact on quality of life, well-being and functional outcome. Patients with schizophrenia have dramatically higher levels of cardiovascular and metabolic morbidity than the general population due to poor physical fitness and to sedentary lifestyle. They have a reduced life expectancy, and an excess mortality being two or three times more than that in the general population. Moreover, despite major therapeutic advances in the overall management of these patients, some symptomatic dimensions, and more specifically the negative and cognitive ones, remain to be resistant to the usual pharmacological approaches. Moreover, antipsychotics can also reinforce the global cardiovascular risk due to side effects and low neurometabolic tolerance. The benefits of physical activity on health are now well described in the general population and in many medical diseases. More recently, physical activity has also found its place as an adjuvant therapy in severe mental illnesses, particularly in schizophrenia. In the literature physical activity programs, in addition to pharmacological treatments, appear to be feasible in patients and improve both physical and mental health as well as functional outcome. Clinical benefits of physical activity would be underpinned by biological and cerebral mechanisms, which remain unclear. In this review, we propose to present a state of the art and to present an update of the interests of physical activity in the management of patients with schizophrenia. We emphasize the clinical benefits of physical activity regarding the different symptomatic dimensions and its impact specifically on cognitive deficits. Finally, we describe the various underlying pathophysiological mechanisms in particular in the neurobiological, cerebral and physiological fields. We then discuss the barriers, facilitators and motivating factors towards physical activity to enhance health promotion initiatives, to optimize resource allocation when delivering physical activity programs in clinical practice, and to maximize physical activity participation. Physical activity appears to be an original and novel adjunctive therapeutic approach in the management of patients with schizophrenia and would both reduce schizophrenic symptoms and act like pro-cognitive therapy, improve quality of life and long-term functioning in daily life and reduce cardiovascular comorbidities. However, efforts are still needed to increase the motivating factors and adherence towards physical activity participation for people with schizophrenia.