Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg最新文献

Unlabelled: In Luxemburg, the national breast cancer mammography screening programme has been running for 18 years. The Coordinating Centre treats approximately 17,000 files a year. The Health Directorate, as promoter of the "Programme Mammographie", is obliged to provide itself with a maximum of guarantees; within the framework of its legal missions, it has to implement all the possible means in order that the whole approach assures minimal adverse effects. The technical quality of the 9 centres is at the level required by the European Guidelines for Quality Assurance in Mammography Screening and Diagnosis, 4th edition. The quality of the readings was already the subject of 2 evaluations of the performance of the readers: the mean accuracy of the first readers to detect cancers is 87%, of the second readers 97%. The mean recall rate for assessment is about 6%. The double reading assures the detection of between 15 and 21% additional cancers, depending on the years. The imaging of diagnostic assessment has been the subject of a retrospective study. Out of 392 cancers, time from assessment to diagnosis was longer then 24 months for 17 women (4%). Examples are described and reasons for negative assessment are listed. The main cause is the multiplicity of the doctors acting in the assessment process, resulting in a default of the examination synthesis and a certain lack of communication and multidisciplinary approach. More convergence in diagnostic breast assessment and a shortening of delays between screening and diagnosis, are desirable.

In conclusion: The evolution towards Specialist Centres for breast cancer care answers an ethical obligation which the initiators of a public health programme have to assume, such as the organization of a high quality breast cancer screening programme.

Models for financial asset dynamics usually take into account their inherent unpredictable nature by including a suitable stochastic component into their process. Unknown (forward) values of financial assets (at a given time in the future) are usually estimated as expectations of the stochastic asset under a suitable risk-neutral measure. This estimation requires the stochastic model to be calibrated to some history of sufficient length in the past. Apart from inherent limitations, due to the stochastic nature of the process, the predictive power is also limited by the simplifying assumptions of the common calibration methods, such as maximum likelihood estimation and regression methods, performed often without weights on the historic time series, or with static weights only. Here we propose a novel method of "intelligent" calibration, using learning neural networks in order to dynamically adapt the parameters of the stochastic model. Hence we have a stochastic process with time dependent parameters, the dynamics of the parameters being themselves learned continuously by a neural network. The back propagation in training the previous weights is limited to a certain memory length (in the examples we consider 10 previous business days), which is similar to the maximal time lag of autoregressive processes. We demonstrate the learning efficiency of the new algorithm by tracking the next-day forecasts for the EURTRY and EUR-HUF exchange rates each.

Questing one's personal identity and developing a coherent representation of oneself, the other and the world are major tasks in adolescence. Research showed that a satisfactory resolution of the crisis of adolescence can be favoured by psychological counselling based on artistic mediations. The objective of this study consisted in exploring the effect of music on the pictorial expression of a non clinical sample of female adolescents (N=157) aged from 17 to 28 years. We analysed free drawings realised by the test group with the help of a rating scale constructed in a phenomenological and structural perspective (Schiltz, 2006). The adolescents painted under musical induction. We proposed three different styles of music, i.e. baroque music (Georg Friedrich Händel and Johann Sebastian Bach), classical music (Wolfgang Amadeus Mozart and Ludwig van Beethoven) and polish ethnical music (Kapela ze Wsi Warszawa-Warsaw Village Band). By using non parametric inferential and multi dimensional statistics, we could show that structural characteristics of music styles lead to differences in formal and content variables on the rating scales for the pictures. The results of our exploratory study open some tracks for future research. It would be pertinent to enlarge the population to other categories of age and to investigate the influence of gender.

Autoimmune lymphoproliferative syndrome (ALPS) is a rare disease caused by defective lymphocyte apoptosis and is characterized by non-malignant lymphoproliferation, hepatosplenomegaly, autoimmune manifestations and increased risk of both Hodgkin's and non-Hodgkin's lymphoma. Most forms of the disease are due to germ line mutations of the FAS gene and manifest during the first years of life with fluctuating lymphadenopathies, hemolysis, immune thrombocytopenia. During the second decade of life disease manifestations improve spontaneously but autoimmune problems still occur and there is an increased risk of lymphoproliferative malignancy. We describe a typical case of ALPS in a now 44 year old man, followed since the age of 2 for disease manifestations that were unclear at the beginning.

The aim of our study is to show the relevance of art therapeutic treatment with an alcoholic population met in the weaning department of a general hospital. A current tendency of research in psychology consists in using an integrated quantitative and qualitative methodology. This approach is especially suited to the study of the therapeutic intervention. In arts therapeutic research the investigation of the artistic production and the application of a projective test (Rotter) may complete the psychometric tools: SVF 78 Stressverarbeitungsfragebogen by Janke W., Erdmann G., Kallus W.; MDBF Mehrdimensionalen Befindlichkeitsfragebogens by Steyer R., Schwenkmezger P., Notz P., Eid M.. The results of the study show the relevance of our art therapeutic treatment. We are going to illustrate the multidimensional reality of the therapeutic process by two clinical examples.

Herpes encephalitis can be a life-threatening condition, despite early instauration of acyclovir treatment. In particular patients may succumb to rapidly progressive cerebral oedema. We report a 66-year patient with a Glasgow Coma Score (GCS) of 6 and incipient uncus herniation of the right temporal lobe on the third day. Decompressive hemicraniectomy was immediately performed. The long-term outcome was satisfactory with unassisted gait and a Barthel Index score of 70 after 9 months.

We present a manuscript from the 18th century, an extract taken from the "Great and the Little Albert" attributed to Albertus Magnus. The linguistic variety in the paper is typical for a text composed in Luxembourg. Added to this text are two incantations and a short cartomancy paper.

Elderly persons are often depressive; thus they are in loss of desire and motivation. They don't take care anymore of themselves and seem disembodied. It is exactly on this loss of desire that arts therapies have an impact. This involvement of the body facilitates the awareness of one's often unexploited capacities but also allows the emergence of pleasure and finally desire. Arts therapies are based on the conscience of here and now, with the perspective to become a creative being. It is the matter of helping people to recognize their own creativity that was underestimated by themselves up to here. These sessions allow the patients to go out of their room while bringing them a sensation of relaxation and well-being. They are proud to produce something by themselves and recover thus a certain self-esteem. And, through this activity, they are able to express what they feel. The statistical computations are made with the data of 10 elderly persons aged 77 to 95 years. We analyze the rating scales for self-expression through movement during 10 sessions. The subjects also filled in the Campbell's Index of Well-being in T1 and T2. Arts therapies improve in a significant way the cognitive functioning and the psychological well-being of elderly persons, as well as their quality of life.

Unlabelled: Practice of a sport is associated with better health but it can also be linked to behavioral disorders of adolescents. It is therefore necessary to identify what influences these health problems.

Objective: We evaluated the effect of sports motivation and achievement goals on the substances use of adolescents using the PLS approach. A proposal for modelling with latent variables creating motivational and consumption of substances has been conducted among adolescents over a period of 20 months.

Method: This research was conducted among 105 adolescents aged an average of 17 years.

Results: The analysis of data in PLS has revealed the essential role of sport motivation and achievement goals in the behavioral disorders in adolescence. We also made a comparison of PLS with a statistical regression classic.