[Psychiatry and medical anthropology: working together?].
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Biomedical subjects
Publications and source records attributed to J Benoist.
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A first level of immateriality of the human body is very classic for anthropologists: it concerns the different conceptions of soul, of a supernatural component of the human being. It refers also to different kinds of continuity and exchange between the human body and society. The other immateriality appears as an answer to the biological reductionism of the body. As we can see in biomedical conception of the body, as well as in different totalitarian utopias, biological reductionism tends to reduce the whole person to its biological body. Consciously or unconsciously, people cannot accept it. Contemporary ways of healing reflect this contradiction: people accept biological knowledge but they do not accept a purely biological conception of their own body. They conceive that there is an immaterial part in the human body; however it is not supernatural but a part of nature. In this way this 'not divine immateriality' can be conciliated with some kind of scientific approach. The refusal to enclose the person in the biological body appears as a constant through human societies. At the medical level, this refusal is always present in the ill person's image of his body and of his illness. At a more general level, this refusal is probably necessary in order to keep human freedom as well as human specificity.
The effect of nasal continuous positive airway pressure (CPAP) was assessed in three patients with tracheobronchomalacia (TBM) who failed conventional medical management. Using physiologic measures of airflow and fiberoptic bronchoscopy, we evaluated expiratory airflow and airway collapse during the acute administration of nasal CPAP. FVC increased and dynamic airway collapse [slow vital capacity minus forced vital capacity (SVC--FVC)] decreased with increasing levels of CPAP. Notching associated with airway collapse was observed in the baseline spirograms of all three patients, and it disappeared with the addition of nasal CPAP. Fiberoptic bronchoscopy confirmed the severity of TBM in each patient and documented an acute improvement in expiratory airway collapse with the addition of nasal CPAP. Intermittent nasal CPAP was then added to the patients' treatment regimens, improving the course of their disease. Specific treatment outcomes varied from patient to patient, but they included improved sputum production, atelectasis, exercise tolerance, and patient symptoms plus reduced need for medical care. These findings suggest that the addition of intermittent nasal CPAP to routine medical therapy may be of benefit to patients with severe TBM unresponsive to conventional medical management.
Red cell antigens [A,B,H,C,c,C(w),D,E,e,M,N,S,s,P1,K,FY(a),JK(a)] and 20 serum proteins or erythrocyte enzymes were tested in a white isolate of the French West Indies (the island of St-Barthélémy). The genetic differentiation mainly due to genetic drift and founder effect between France and this isolate and between the Leeward (parish of Gustavia) and Windward (parish of Lorient) areas within the island is discussed. Genetic admixture with black populations of African origin is very low.
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Saint-Barthélémy, a small island near Guadeloupe, has been isolated since the 18th century. A first estimation of genetic size at each generation gives an estimation of the present inbreeding value due to random genetic drift. It is of the order of half a per cent. A census of matings between closely related persons (first or second cousins), during the three last generation may provide an estimation of the inbreeding value related to choice of mates based on relatedness using Sutter's equation of apparent consanguinity. This estimation is of the same order (0.8%) but is restricted to the cumulative effect of random genetic drift and non-random mating between relatives during these three last generations. A full estimation of remote consanguinity at present time requires a detailed analysis of genealogies.
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