[Epidemiological study on addictive behaviours during pregnancy in a universitary department]. / Étude de prévalence des conduites addictives chez les femmes enceintes dans une maternité universitaire.

OBJECT: Epidemiological study on addictive disorders during pregnancy. METHODS: An epidemiological study about addictive disorders has been led in the maternity of the University Hospital of Nantes in 2008 on a sample of 300 women, just after childbirth. The prevalence of consumption of drugs was assessed on declared consumption of legal and illegal substances and on the Fagerström questionnaire, the AUDIT questionnaire and the CAST questionnaire. Diagnostic of eating disorders was based on DSM IV criteria of mental anorexia and bulimia nervosa. RESULTS: At the beginning of pregnancy, 34% of women used tobacco, 63% alcohol and 8% cannabis. Among the women of the study 0.7% had criteria for mental anorexia, 2.3% for bulimia nervosa and 9% for sub clinic forms. After the first trimester, 22% of women declared using tobacco, 20% alcohol and 3% cannabis. The use of various drugs during pregnancy concerned 6.3% of women, and 38% used at least one drug after the first trimester. CONCLUSION: The high prevalence of addictive disorders during pregnancy should incite professional of prenatal care to improve their screening methodology and not only when tobacco or alcohol is suspected.

Primary and memory T cell responses induced by hepatitis C virus multiepitope long peptides.

To develop a vaccine against hepatitis C virus, we synthesized four long peptides from nonstructural proteins NS3, NS4 and NS5B containing HLA-class I and class II epitopes mainly inducing responses in natural infection. In HLA-A2.1 transgenic mice, the four peptides primed higher CTL responses to 6:7 minimal HLA-A2 epitopes than those induced by the minimal epitopes. HLA-A2.1/HLA-DR1 transgenic mice immunized with one peptide, containing a class II epitope implicated in viral resolution, developed IFNgamma-producing CD4+-T and CD8+-T cells. These peptides recalled HCV-specific IFNgamma-producing cells from HCV-infected patients' PBMC. This support the selection of these domains for inclusion in a vaccine formulation.

[47-year course of severe lymphedema of the right lower limb. 6 successive operations from 1941 to 1950. Satisfactory condition 36 years after the last operation]. / 47 ans d'évolution d'un lymphoedème important du membre inférieur droit. 6 opérations successives de 1941 à 1950. Etat satisfaisant 36 ans après la dernière opération.

Mrs. T... (born in 1920) consulted Pr R. Leriche in 1941 for severe lymphoedema of the right leg present since 1939 following fly bites. Elastic contention was insufficient. Lumbar sympathectomy performed in 1941, subcutaneous-aponeurotic resections of the lateral aspect of the leg in 1942, extended in 1946 (R. Leriche) and completed by a wide excision of the posterior aspect in 1948 (Pr Goinard, Alger) only provided temporary improvements. In 1949, five polyethylene tubes were inserted under the skin of the calf at the root of the thigh (Kunlin and Boely). Three catheters had to be removed after several months because of the risk of cutaneous perforation and secondary infection. In 1950, in view of the inadequate results, ten nylon threads were inserted into the subcutaneous tissue from the ankle to the lower abdominal wall and a very extensive resection of the subcutaneous tissue (to the level of the dermis) and the aponeurosis was performed on the medial aspect of the leg (K. and B.). A dramatic improvement was obtained, which persisted until the beginning of 1986, i. e. 36 years after this last operation. Unfortunately, oedema has gradually appeared in the other leg over the last 4 to 5 years. Despite the various treatments attempted, the volume of this leg is now greater than that of the operated leg and is associated with increasing discomfort for the patient (Table of measurements). A calcified sheath has formed around the two remaining polyethylene tubes.

[Destruction of residual varicose collaterals by subcutaneous dilaceration with a needle]. / Destruction des collatérales variqueuses résiduelles par dilacération sous-cutanée a l'aiguille.

The persistence of collaterals after a properly conducted surgical treatment of varicose veins of the lower limbs often presents a problem which is difficult to resolve. The authors put forward a simple and original method, in which a long and slightly curved triangular needle is used, without incisions, to destroy by dilaceration the collaterals whatever their degree of dilatation and their location. This technique has also been used as a first stage preceding stripping, and over a 5 year period has given results in 70 patients which are very satisfactory both from the point of view of efficacy as well as from the aesthetic point of view.

[Plea for better terminology in surgery of the profunda femoris artery (author's transl)]. / Plaidoyer pour une meilleure terminologie de la chirurgie de l'artère fémorale profonde.

Surgical publications on the profunda femoris artery rarely give information on the site of the operation and the technic used. Experience of 356 operations carried out from 1949 to 1978 by the authors and anatomical dissection of 100 profunda femoris arteries is reported. They suggest the elimination of all imprecise terms at present attached to these operations and their replacement by a more lengthy but more understandable vocabulary, together with an attempt to classify the profunda femoris artery in two groups and its nomenclature in 4 segments, more adaptable to surgery of this artery.