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Objectives: The first aim of this study was to evaluate the access of independent midwives to the technical facilities of a level-1 maternity hospital, with a follow-up of 2 years. The second aim was to evaluate the transfer of clinical responsibility, when a patient stops being managed by the independent midwife to be taken care of by the hospital team., Patients and Methods: A retrospective study including 51 patients. Analysis of maternal and perinatal data., Results: Of the 51 births, there were 42 vaginal deliveries without intervention (82.35%), 3 instrumental deliveries (5.88%), 6 caesarean sections (11.76%). The midwife-led care was completed in 70.59% of cases. The rate of transfer of clinical responsibility during labor was 25.49%. We conducted a neonatal transfer due to a respiratory distress syndrome., Discussion and Conclusion: The access to technical support appears as an opportunity for independent midwives to establish a special relationship with their patients. However, this device preserves the possibility of a traditional hospital care when needed. This way, access to the technical support is a safe alternative that has the consent of the users (patients and midwives) as well as of the entire hospital team. Moreover, such device allowed an increase of 5% per year of our obstetrical activity with an estimated increase of 10% per year., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Von Hippel-Lindau (VHL) disease is a hereditary cancer syndrome that predisposes to the development of a panel of highly vascularized tumors including CNS and retinal hemangioblastomas, endolymphatic sac tumors, clear-cell renal cell carcinomas (RCC), pheochromocytomas and pancreatic neuroendocrine tumors. CNS hemangioblastomas and RCC are the two main life-threatening manifestations. The disease is caused by germline mutations in the VHL tumor-suppressor gene that plays a major role in regulating the oxygen-sensing pathway by targeting the hypoxia-inducible factor HIF for degradation in proteasome. Somatic inactivation of the VHL gene occurs also in most sporadic RCC and sporadic CNS hemangioblastomas. The demonstration of the critical role of VHL in angiogenesis is paving the way for the development of new specific drugs that could represent an attractive potential treatment for VHL but also for sporadic RCC and other cancers.

In this study, our aim was to analyse the prescriptions of drugs used to improve Alzheimer's disease at CHS Paul Guiraud. This study was carried out a posteriori on 16 hospitalized patients. We have seen that for our patients there is no general rule, nor therapeutic scheme but the choice of treatment is carried out according to the professional experience of the physician. The treatment therefore is composed of symptomatic drugs alone or associated with etiologic drugs. Eleven anxiolytic or hypnotic drugs were prescribed. Alimemazine is the most prescribed in the sixteen cases. The preferential use of this drug can be explained by its presentation in the form of drops. In two cases, behavioural improvements were noted, in two other cases, we noted accentuation of dementia. Meprobamate used in seven cases of the sixteen, was never used alone. We find neuroleptics in fifteen of the sixteen cases studied: In seven cases they were administered from the beginning of the hospitalisation; for the others they were introduced later during a phase of agitation or delirium. On the whole, they were effective on aggressive agitation, in particular thioridazine. Eight of the patients, were treated with halopéridol. In two cases, the behaviour disorders were not stopped; in four cases, there was a worsening of dementia. We noted depression in 6 cases from the beginning of hospitalization, and two cases during hospitalization. The anti-depressive drugs besides their main effect, reduce also anxiety. In two cases, we observed an aggravation of disorientation and confusion following of the prescription of amitryptiline and mianserine.(ABSTRACT TRUNCATED AT 250 WORDS)

A neurophysiological study of 4 benzodiazepines in the free implanted cat serves as basis to a discussion concerning tranquilizers, anxiety and vigilance. The electrophysiological and behavioural effects of diazepam, nitrazepam, lorazepam and of clorazepate dipotassique are analysed and compared between them and other psychotropic drugs. Their mode of action on the behaviour, on the bioelectric cortical and hippocampal rhythms, is explained according to recent biochemical data. The relations with anxiety, vigilance and neuro-psycho-physiologic mechanisms which subtend them are discussed at the light of clinical effects provoked by substances called tranquillizers.

The study of the sleep awakening cycle was carried out on implanted cats free of their movements, which received separately each drug in long lasting intake, inorder to differentiate their behavioural and electrophysiological activities. The qualitative and quantitative changes induced by these o-anisamides are reported. Like in man, sulpiride was found to be quite an original substance. It may be distinguished from the other psychotropic drugs studied because it has no effect on the sleep awakening cycle. The effects of sultopride are comparable with those of some neuroleptics, although its both incisive and sedative activity is very special. The neurophysiological results are discussed in the light of other studies and clinical data.

The study of the sleep awakening cycle was carried out on implanted cats free of their movements, which received separately each drug in long lasting intake, in order to differentiate their behavioural and electrophysiological activities. The qualitative and quantitative changes induced by these o-anisamides are reported. Like in man, sulpride was found to be quite an original substance. It may be distinguished from the other psychotropic drugs studied because it has no effect on the sleep awakening cycle. The effects of sultopride are comparable with those of some neuroleptics, although its both incisive and sedative activity is very special. The neurophysiological results are discussed in the light of other studies and clinical data.

The Doppler ultrasound diagnosis of carotid artery stenosis (asymetrical systolic and diastolic flows; elevated resistance index: ratio of flow pulse amplitude to systolic and diastolic values; flow reversal in the ophtalmic artery) is compared, in 52 patients, to the clinical, angiographic (40 patients) an surgical findings and to the peroperative measure of intra-arterial pressure and flow (30 patients). Its reliability is proved as a guide for angiographic exploration and for postoperative watching, but it is restricted to great vessels (cervical carotid artery) and is unable to detect ulcerated plate without stenosis.