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Sin-le-Noble, France

Bence C.,Service dAddictologie | Bonord A.,Service de Prise en Charge de la Toxicomanie et de la Dependance | Rebillard C.,Service de Psychiatrie Perinatale | Vaast P.,Center Pluridisciplinaire Of Diagnostic Prenatal | And 5 more authors.
Pediatrics | Year: 2016

Tianeptine, an atypical antidepressant, has been found to exhibit a potential for abuse. The use of therapeutic doses of tianeptine during pregnancy has never raised safety concerns. However, the impact of tianeptine abuse on the mother-child dyad has never been assessed. We report herein the case of a female patient who presented with dependence on tianeptine, with the use of >650 mg of the drug per day. She had 2 successive pregnancies with similar doses. The state of dependence remained unidentified throughout the first pregnancy, but just after delivery, her full-term newborn exhibited unexpected neonatal abstinence syndrome (NAS). The NAS was successfully treated with morphine, although both the mother's and newborn's urine drug screen was negative. The causality of tianeptine in inducing NAS was retrospectively assessed as "probable" by using a validated causality algorithm. During the second pregnancy, this patient sought addiction treatment and was admitted for residential detoxification treatment in her seventh month of pregnancy. Delivery occurred at full term with a low birth weight neonate. No further developmental insults or medical problems were subsequently identified in the 2 children. Maternal tianeptine dependence during pregnancy may induce a type of NAS that mimics opiate NAS. This finding appears to be consistent with a recent finding of the agonist action of tianeptine on the opiate μ-receptor. © 2016 by the American Academy of Pediatrics. Source

Hammelin J.-P.,Service Route | Cardon G.,Service Route | Reberolle M.,Service Route | Moulonguet F.,Service Route | And 4 more authors.
Revue de Medecine Interne | Year: 2016

Introduction: AA amyloidosis is a common but severe complication of many chronic inflammatory processes of infectious, autoimmune, or neoplastic origin. It frequently leads to renal damage, often presenting as a nephrotic syndrome. Giant cell arteritis is a common inflammatory arteritis in elderly people, but rarely complicated by AA amyloidosis. Case report: We report an 87-year-old female who presented with a nephrotic syndrome and a chronic inflammation, in whom the kidney biopsy showed secondary amyloidosis. Etiological investigations concluded an amyloidosis related to giant cell pan-aortitis, whereas there were no typical clinical signs for this diagnosis. Outcome was rapidly unfavourable despite the treatment. Conclusion: In case of chronic inflammation of unknown origin in elderly patients, aortitis complicating a giant cell arteritis should be looked for with imaging techniques, as clinical diagnosis of this presentation is difficult, whereas delayed diagnosis exposes to severe or fatal issues. © 2016 Société Nationale Française de Médecine Interne (SNFMI). Source

Deprez A.,Center Devaluation Et Of Traitement Of La Douleur | Duneugardin P.,Center Hospitalier Of Douai
Douleur et Analgesie | Year: 2016

The links of primary attachments are essential in the development of the child and participate in identity construction. Numerous authors dealt with the theory of attachment and allowed us to better understand few concepts.With the help of this theory’s authors pioneers, we are interested, in this article, in the psycho-emotional development of the child by means of the link mother-child organized through the face and the attention dedicated to the child. © 2016 Springer-Verlag France Source

Nohuz E.,Service Route | Schumacher J.-C.,Center Hospitalier Of Mulhouse | Alaboud M.,Service Route | Dalkilic S.,Center Hospitalier Of Longjumeau | And 10 more authors.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction | Year: 2012

Restructuring the surgery and gynecology-obstetrics departments taking place now raise many interrogations. It appears as a mandatory necessity to some people and as a tribute to financial strategies to others to the detriment of quality and accessibility of care. Its effect is to clarify a good amount of socioeconomical and medical indicators. The plans of perinatality for the obstetrical aspect and the thresholds of activity for the surgical aspect constitute the major lines of these restructurings. A survey soliciting all the French public hospitals was used to assess the state of obstetrics and gynecology departments in the light of these recent restructurings. Medical demography, preserving and improving the quality and continuity of care, efficiency of the technical supports are discriminating criteria of the involved challenges. Such restructurings have an impact on the doctor's lives, which looks globally positive and a good omen to complete this remodeling process. The activity was safeguarded by a redistribution and a refocusing of institutions. One should not minimize the social impact of these changes, with a potential deterioration of working conditions (internal professional reclassifications, mobility obligation towards other sites). It thus appears that the deep changes which affect the small size institutions will be able to achieve well only if they are clearly done (information) and truly integrated in their medical project. © 2012 Published by Elsevier Masson SAS. Source

Gnemmi V.,Lille University Hospital Center | Gnemmi V.,University of Lille Nord de France | Leleu X.,Lille University Hospital Center | Provot F.,Lille University Hospital Center | And 3 more authors.
American Journal of Kidney Diseases | Year: 2012

Waldenström macroglobulinemia is a rare low-grade hematologic malignancy due to clonal proliferation of B lymphocytes responsible for immunoglobulin M (IgM) monoclonal gammopathy secreted in serum. This disease is characterized by lymphoplasmacytic tumoral infiltration of bone marrow and various organs, especially the liver and spleen. Kidney involvement in Waldenström macroglobulinemia has been described previously with reports of various forms of glomerular injury: large intracapillary IgM pseudothrombi, cryoglobulinemia-associated membranoproliferative glomerulonephritis, or amyloidosis. Interstitial infiltration by tumoral B lymphocytes is another classic pattern. Conversely, tubular involvement in the form of myeloma-like casts or basement membrane deposition of monoclonal light chain (light-chain deposition disease) is unusual. We report the occurrence of cast nephropathy associated with light-chain deposition disease in 2 patients with Waldenström macroglobulinemia, which resulted in severe and prolonged kidney failure. © 2012 National Kidney Foundation, Inc. Source

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