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Ghesquiere L.,Pole Femme Mere Nouveau ne | Deruelle P.,Pole Femme Mere Nouveau ne | Deruelle P.,Lille 2 University of Health and Law | Charbonneau P.,Comite national dexperts sur la mortalite maternelle CNEMM | Puech F.,University droit et sante Lille
Journal de Gynecologie Obstetrique et Biologie de la Reproduction | Year: 2014

Although deaths caused by infection during pregnancy and the postpartum period are rare in France, mortality rates have increased in several countries of the European community. In France, the rate of maternal mortality by infectious cause has decreased over the last 12 years. Infectious causes are currently in fifth place of maternal deaths. Over the period 2007-2009, 18 deaths occurred, eight by direct infectious causes and 10 by indirect infectious causes. Among the 18 deaths, 17 were examined by the National Expert Committee on Maternal Mortality (CNEMM) with the objectives to determine the direct or indirect link with pregnancy, the adequacy of care and the preventability of death. Among 8 deaths from direct infectious causes, four deaths were deemed "preventable" or "possibly preventable" because of inadequate care. Among nine deaths from indirect infectious causes, preventability could not be established in two deaths, five were non-preventable and two were preventable due to non-optimal care. These cases of puerperal septicemia show that when sepsis is clinically manifest, infection is already well established and widespread deterioration is therefore often irreversible. Maternal mortality is preventable in most cases if several points are observed: early diagnosis, probabilistic antibiotics targeting most frequently involved bacteria including Escherichia coli and Streptococcus A, early transfer to ICU, control septic portal entry, simple preventive measures, influenza vaccination. A "microbiological clinical diagnosis" approach must be initiated at the first clinical signs. © 2014 Elsevier Masson SAS. All rights reserved.


Ghesquiere L.,Pole Femme Mere Nouveau ne | Deruelle P.,Pole Femme Mere Nouveau ne | Charbonneau P.,Comite national dexperts sur la mortalite maternelle CNEMM | Puech F.,University droit et sante Lille
Journal de gynécologie, obstétrique et biologie de la reproduction | Year: 2015

Although deaths caused by infection during pregnancy and the postpartum period are rare in France, mortality rates have increased in several countries of the European community. In France, the rate of maternal mortality by infectious cause has decreased over the last 12 years. Infectious causes are currently in fifth place of maternal deaths. Over the period 2007-2009, 18 deaths occurred, eight by direct infectious causes and 10 by indirect infectious causes. Among the 18 deaths, 17 were examined by the National Expert Committee on Maternal Mortality (CNEMM) with the objectives to determine the direct or indirect link with pregnancy, the adequacy of care and the preventability of death. Among 8 deaths from direct infectious causes, four deaths were deemed "preventable" or "possibly preventable" because of inadequate care. Among nine deaths from indirect infectious causes, preventability could not be established in two deaths, five were non-preventable and two were preventable due to non-optimal care. These cases of puerperal septicemia show that when sepsis is clinically manifest, infection is already well established and widespread deterioration is therefore often irreversible. Maternal mortality is preventable in most cases if several points are observed: early diagnosis, probabilistic antibiotics targeting most frequently involved bacteria including Escherichia coli and Streptococcus A, early transfer to ICU, control septic portal entry, simple preventive measures, influenza vaccination. A "microbiological clinical diagnosis" approach must be initiated at the first clinical signs. Copyright © 2014 Elsevier Masson SAS. All rights reserved.


Ameller A.,University of Lille Nord de France | Ameller A.,University Droit et Sante Lille | Ameller A.,Louis Mourier Hospital | Dereux A.,Louis Mourier Hospital | And 13 more authors.
Schizophrenia Research | Year: 2015

Background: Familiarity disorders (FDs) critically impact social cognition in persons with schizophrenia. FDs can affect both relationships with people familiar to the patient and the patient's relationship with himself, in the case of a self-disorder. Skin conductance response (SCR) studies have shown that familiar and unknown faces elicit the same emotional response in persons with schizophrenia with FD. Moreover, in control subjects, one's own face and familiar faces have been shown to activate strongly overlapping neural networks, suggesting common processing. The aim of the present study was to determine whether the mechanisms involved in processing one's own and familiar faces are similarly impaired in persons with schizophrenia, suggesting a link between them. Method: Twenty-eight persons with schizophrenia were compared with twenty control subjects. Three face conditions were used: specific familiar, self and unknown. The task was to indicate the gender of the faces presented randomly on a screen during SCR recording. Face recognition was evaluated afterwards. Results: Control subjects exhibited similar SCRs for the familiar and self-conditions, which were higher than the responses elicited by the unknown condition, whereas persons with schizophrenia exhibited no significant differences between the three conditions. Conclusion: Persons with schizophrenia have a core defect of both self and familiarity that is emphasised by the lack of an increased SCR upon presentation with either self or familiar stimuli. Familiarity with specific familiar faces and one's own face may be driven by the same mechanism. This perturbation may predispose persons with schizophrenia to delusions and, in particular, to general familiarity disorder. © 2014 Elsevier B.V.

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