Symptomatic sinus bradycardia, due to either sick sinus syndrome or vagotonia, can be familial, affecting several members of a family. We report an 18-year-old male patient with palpitations and limited exercise capacity who was noted to have severe sinus bradycardia. His resting heart rate was 40/min, with normal PR and corrected QT intervals, and sinus pauses up to 6 seconds during sleep. Exercise treadmill test and pharmacologic autonomic blockade during electrophysiologic studies abolished the bradycardia, suggestive of vagotonia rather than intrinsic sinus node dysfunction. This patient's father and a female cousin had a similar clinical history but associated with syncope and severe sinus bradycardia. The mode of transmission appeared to be autosomal dominant. All three have permanent demand pacemakers implanted and are asymptomatic.

Cette thèse de doctorat étudie la prise en charge des pratiques contraceptives, de l’avortement et de l’éducation sexuelle par des catholiques organisant, à partir des années 1950, des centres de consultation conjugale et de planning familial en Belgique. À l’aide d’une méthode socio-historique, j’ai examiné le processus de création d’une normativité pratique et discursive et d’une gouvernementalité sexuelle propres au monde catholique, au sein d’une société belge clivée et pluraliste aux prises avec la révolution sexuelle. J’ai ainsi mis en évidence la constitution d’une configuration normative qui légitime l’usage de la pilule contraceptive en la conditionnant à l’éducation à la sexualité et, en contrepartie, construit l’avortement comme un échec de la contraception et d’une conduite sexuelle responsable. La notion de "gouvernement par la parole" rend possible l’investissement des catholiques dans la défense des droits reproductifs. / Doctorat en Sciences politiques et sociales / info:eu-repo/semantics/nonPublished

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20563号 / 医博第4248号 / 新制||医||1022(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 生田 宏一, 教授 髙折 晃史, 教授 前川 平 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21635号 / 医博第4441号 / 新制||医||1034(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 椛島 健治, 教授 岩田 想, 教授 山田 亮 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DGAM

Hester Pulter’s (1605-1678) work was discovered in 1996 in the Brotherton Library at the University of Leeds. Pulter composed her poetry in the 1640s-1650s, but her works were not compiled until the 1660s. Overall, her manuscript contains one hundred and twenty poems and emblems in addition to an unfinished prose romance. Pulter recalls her personal life in her poems, and the collection includes her elegiac and lyrical poems on different topics such as politics, religion, childbirth, and the death of her children. In her elegiac poetry, Pulter explores of the experience of childbirth and sickness through a set of conventional Christian ideas about death. However, Pulter’s elegiac poetry also breaks away from Christian conventions, often through the use of astronomical imagery. In this thesis, I argue that Pulter’s grief and consolation strategies sometimes differ from her contemporaries; however, she eventually finds consolation using imagery drawn from her knowledge of the new astronomy, allowing her to reconstruct her identity. Through comparing Pulter with her contemporaries such as George Herber, Katherine Philips, and John Donne, Pulter’s poetry, which has been unstudied until recently, provides an example of a woman writer who is familiar with the seventeenth century poetical conventions; however, she is able to alter them to what is relevant to her condition.

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The relationship between DSM-IV anxiety disorders and their clinical characteristics in mothers and anxiety in offspring was examined in 933 mother-child pairs from a longitudinal community study. Offspring of mothers with an anxiety disorder had an elevated risk of developing any anxiety disorder, compared with offspring of mothers with no anxiety disorder. Increased risk of anxiety in the offspring was especially associated with maternal social phobia and generalised anxiety disorder, and with maternal diagnoses of early onset, greater number and more severe impairment. These results suggest that the type of maternal anxiety disorder and its severity of manifestation contribute to mother-offspring aggregation of anxiety.

In severe cases of ulcerative colitis (UC) unresponsive to current treatment options, patients require a complete proctocolectomy, or surgical removal of the colon. Ileal pouch anal anastomosis (IPAA) has become the preferred surgical technique for patients who require surgery, as this method restores rectal function. This procedure is also used to treat colorectal cancers such as adenocarcinoma and familial adenomatous polyposis (FAP). The surgery involves an abdominal colectomy with the construction of an ileal pouch created from folded tissue recovered from the ileal portion of the small intestine. Up to 50% of patients who require IPAA surgery experience an episode of pouchitis, a non-specific inflammation of the constructed ileal pouch with unknown etiology. Several hypotheses have been proposed regarding the pathogenesis of pouchitis. Current theories include bacterial overgrowth due to fecal stasis, microbial imbalance (dysbiosis), immune alteration, genetic susceptibility, metaplasia, ischemic complications of surgery, a recurrence of UC, or even a novel form of inflammatory bowel disease. The efficacy of antibiotics and probiotics in treating pouchitis and maintaining remission underscores the importance of gut microbiota in the development of this condition. In the study, we aimed to characterize the intestinal bacterial communities that inhabit IPAA pouches of both UC and FAP patients, in an effort to investigate the hypothesis that bacterial dysbiosis is involved in the pathogenesis of pouchitis. Mucosal biopsy and stool samples were analyzed from patients with UC and pouchitis (UCP), healthy UC controls (HUC) and healthy pouches with a background of FAP (FAP). Samples were examined through analysis of terminal restriction fragment length polymorphisms (TRF) and DNA sequencing. The data presented here demonstrate that a microbial imbalance exists in pouchitis, as bacterial communities in pouchitis differ significantly from healthy UC pouches and pouches constructed for FAP. Both methods identified potential groups of organisms that may play a role in the development of pouchitis, including decreases in protective Lactobacillus and Bacteroides and increases in mucin-degrading Clostridium and Akkermansia. A better understanding of the factors driving the pathogenesis of pouchitis will not only benefit patients with this disease, but also lead to a better understanding of the complex relationship that exists between the human host and the diverse community of organisms that inhabit the gastrointestinal tract.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.