Biomedical subjects

Nathalie Jousset

Publications and source records attributed to Nathalie Jousset.

4 recordsLinked to original sources

PubMed2006

[Spectacular suicide associated with mefloquine].

INTRODUCTION: We present a case in which suicide was a severe neuropsychiatric reaction to treatment with mefloquine. Physicians must be aware of these serious psychiatric complications and bear them in mind when faced with atypical behavior or suspected suicide. CASE REPORT: The body of a 27-year-old man was discovered at his home, covered with multiple knife wounds. The autopsy report concluded that death was due to a craniocerebral wound from a violent blow. Homicide was initially suspected. Suicide during acute psychosis associated with mefloquine was suggested, and toxicologic analyses confirmed this hypothesis. DISCUSSION: Serious neurologic and psychiatric adverse events associated with mefloquine (Lariam) have been reported since its introduction in 1985. Mefloquine prophylaxis is recommended for travelers to high-risk areas of chloroquine-resistant plasmodium falciparum. The risk of malarial infection and the proven efficacy of mefloquine to prevent malaria should be weighed against the risk of drug-associated adverse events. Physicians must nonetheless be aware of these serious psychiatric complications, especially when faced with atypical behavior and atypical suicides. The patient's' family and friends should be asked about a possible trips abroad that might have entailed antimalaria treatment, even several months earlier. Testing for mefloquine during toxicological examinations is then essential. The World Health Organization recommendations and contraindications must be followed in prescribing mefloquine.

Adult↗

PubMed2005

Women who kill their children.

UNLABELLED: The killing of a newborn on the day of its birth is known as neonaticide. A child aged 1 through 16 has a different role in the family, and their murder is perceived differently. We would expect mothers charged with filicide to be drawn from a slightly different population than other child-killing mothers. METHOD: Our study was carried out at the Institute of Forensic Medicine in Angers over a 10-year period. All the victims were autopsied at the Institute of Forensic Medicine in Angers. Information concerning the mothers was collected from forensic medical files, police reports, and legal files. Interviews and forensic psychiatric examinations were available for consultation. RESULTS: Our study concerns 17 observations of child-killing mothers and 19 child autopsies. In 2 cases, the issue was in fact a double murder, with the mother killing all the siblings. The mean age was 3.5 years for victims and 29.5 years for the women. The majority of the mothers were married or lived with their partners. They often had an occupation. Generally the economic status was average. Head trauma, strangulation, suffocation, and drowning were the most frequent means of filicide. However, some mothers used more active methods such as striking and shooting. Disturbed or disturbing behavior was documented in 15 perpetrators. Seven women tried to commit suicide. It was often possible to identify apparent motivation for the offense. DISCUSSION: In our study, we can distinguish 2 types of killer mothers. We distinguished a first group made up of 5 mothers. These 5 women killed their children in a general context of abused children and present similarities with the neonaticide mothers (young, immature). The other group of filicide mothers is different. They are generally older, married, and employed. The crime is usually premeditated, committed with the direct use of hands and sometimes very violent. To understand the motives or the source of the impulse to kill, we can use a classification such as Resnick's classification: mothers from the first group fall within the framework of accidental filicides: the risk and prevention factors are those of infanticide and ill treatment. For the other mothers, we can distinguish altruistic filicides (8 cases) and spouse revenge filicides (2 cases). Few of the mothers suffered from real psychiatric problems; however, most of them presented troubles which could have been taken into account. A lot of women showed signs of suicidal tendencies prior to the event, displaying aggressive and angry behavior. In general, suicide attempts tend to prevail. These offenders act out of an acute sensitivity to social regulation. A variety of psychosocial stresses appears to have been a major factor. These stresses include lack of social or marital support, economic difficulties, family stress, and unrealistic expectations of motherhood. The precipitating stress may have been a dispute. Prevention begins with the identification of potential perpetrators. Therefore, medical doctors have a significant role in relation to the prevention of child murder.

Adolescent↗

PubMed2004

Effects of functional restoration versus 3 hours per week physical therapy: a randomized controlled study.

STUDY DESIGN: Randomized parallel-group comparative trial with a 6-month follow-up period. OBJECTIVE: To compare, in chronic low back pain patients, the effectiveness of a functional restoration program, including intensive physical training, occupational therapy, and psychological support to an active individual therapy consisting of 3 hours physical therapy per week during 5 weeks. SUMMARY OF BACKGROUND DATA: Controlled studies conducted in the United States showed a benefit of functional restoration in patients with low back pain, especially on return to work. Randomized Canadian and European trials had less favorable results. In France, there has been up to now no randomized study. Controlled studies suggested a positive effect of functional restoration programs. METHODS: Eighty-six patients with low back pain were randomized to either the functional restoration (44 patients) or the active individual therapy (42 patients) program. One person in each group never started the program. Two patients did not complete the functional restoration program, and one was lost to follow-up at 6 months. The mean number of sick-leave days in the 2 previous years was 6 months. RESULTS: After adjustment on the variable "workplace enrolled in an ergonomic program", the mean number of sick-leave days was significantly lower in the functional restoration group. Physical criteria and treatment appreciation were also better. There was no significant difference in the intensity of pain, the quality of life and functional indexes, the psychological characteristics, the number of contacts with the medical system, and the drug intake. CONCLUSIONS: This study demonstrates the effectiveness of a functional restoration program on important outcome measures, such as sick leave, in a country that has a social system that protects people facing difficulties at work.

Absenteeism↗

PubMed2004

Liability for pharmaceutical products: a difficult attempt at harmonisation.

On the 25 July 1985, the European Community adopted a Directive on liability for defective products. Doctors are very affected by this law because an injured person will possibly be able to take action against them. This directive had several aims: to harmonise member states' legislation concerning the legal protection of victims and to subject producers to the same framework of liability and competition rules. However, this directive currently remains relatively ineffective. Several reasons can be put forward to explain this failure. First, by leaving it open to member states to decide whether to opt for one or more derogations, the Directive has made it easier for different interpretations to emerge. Secondly, several ideas proposed by the Directive have not been defined. As a result, the different legal terminology used in different states makes the interpretation of these concepts more difficult. Our paper concludes that the Directive was soundly based. However, Member States must enquire about the solutions adopted in neighbouring countries, and the ECJ (European Court of Justice) should try to impress on states the importance of a community vision. Without an adequate level of convergence, the differences between national laws will encourage 'forum shopping' on the part of a claimant and the situation will become more difficult for prescribers.

Drug Industry↗