[French validation of the Sexual Addiction Screening Test (SAST-Fr)]. / Validation de la version française du Sexual Addiction Screening Test (SAST-Fr).

INTRODUCTION: The Sexual Addiction Screening Test (SAST) is one of the most frequently used tools on the international level for assessing sexual addiction. This study aimed to translate the English version of the SAST, and adapt and test the psychometric properties of its French version (the SAST-Fr) by establishing its factor structure, internal consistency and convergent validity. METHODS: Three hundred ninety eight voluntary participants were recruited online through specialized forums. Participants completed a sociodemographic questionnaire, the SAST-Fr and the diagnostic criteria of sexual addiction proposed by Goodman. We tested the psychometric properties of SAST-Fr through an exploratory factorial analysis, especially its internal consistency, using the Kuder-Richardson alpha (KR-20) given that the items were dichotomous. We also performed correlation analyses of Bravais-Pearson on numerical variables. Finally, we studied the predictive validity of Goodman's score in predicting SAST-Fr criteria using a ROC (Receiver Operating Characteristics) analysis. RESULTS: Mean age of participants was 29.08 years (±11.30) and included 54% of women (n=215). Statistical analysis had shown that SAST-Fr had a one-factor structure explaining 31% of the variance, an excellent internal consistency (KR-20=0.90). We found significant correlation between SAST-Fr item scores and PEACCE scores (r=0.87; P<0.001) and Goodman's criteria (r=0.79; P<0.001). CONCLUSION: Our results indicate that the psychometric properties of the French version of the SAST are comparable to its original English version with a one-factor structure. The SAST-Fr is a reliable and valid questionnaire to assess symptoms of sexual addiction.

[Smartphone addiction: French validation of the Internet Addiction Test-Smartphone version (IAT-smartphone) and associated psychopathological features]. / L'addiction aux smartphones : validation française de l'échelle Internet Addiction Test-version smartphone (IAT-smartphone) et caractéristiques psychopathologiques associées.

INTRODUCTION: Since their first appearance in 1992 smartphones have improved constantly, and their use, combined with the rapid spread of the Internet, has increased dramatically. The recent emergence of this technology raises new issues, at both individual and societal levels. Several studies have investigated the physical and psychological harm that may be caused by smartphones. The issue of excessive smartphone use as an addictive disorder is frequently raised and debated, although it is not acknowledged in international classifications. In France, there is no validated assessment tool for smartphone addiction. Therefore, the aims of this research were: to validate a French translation of the Internet Addiction Test-smartphone version (IAT-smartphone); to study the links between smartphone addiction, Internet addiction, depression, anxiety and impulsivity. METHOD: Two hundred and sixteen participants from the general population were included in the study (January to February 2016), which was available online using Sphinx software. We assessed smartphone addiction (French version of the Internet Addiction Scale - smartphone version, IAT-smartphone), specificity of smartphone use (time spent, types of activity), Internet addiction (Internet Addiction Test, IAT), impulsivity (UPPS Impulsiveness Behavior Scale), and anxiety and depression (Hospital Anxiety and Depression scale, HAD). We tested the construct validity of the IAT-smartphone (exploratory factor analysis, internal consistency, non-parametric correlation tests for convergent validity). We also carried out multiple linear regressions to determine the factors associated with IAT-smartphone. RESULTS: Mean age was 32.4±12.2 years; 75.5% of the participants were women. The IAT-smartphone had a one-factor structure (explaining 42 % of the variance), excellent internal consistency (α=0.93) and satisfactory convergent validity. Smartphone addiction was associated with Internet addiction (ρ=0.85), depression (ρ=0.31), anxiety (ρ=0.14), and some impulsivity subscales, including "negative urgency" (ρ=0.20; P<0.01), "positive urgency" (ρ=0.20; P<0.01), and "lack of perseverance" (ρ=0.16; P<0.05). Age was negatively associated with the IAT-S total score (ρ=-0.25; P<0.001), and there was a non-significant difference between the IAT-S total scores of men and women (29.3±10.2 vs. 32.7±12.4; P=0.06). Multiple linear regression showed that age, anxiety, depression, average time spent on the smartphone, impulsivity and Internet addiction explained 71.4 % of the variance of IAT-smartphone scores. However, this score dropped to 13.2 % when Internet addiction was removed from the model. This variable alone explained 70.8 % of the IAT-smartphone scores. CONCLUSION: The French version of the IAT-smartphone is a reliable and valid questionnaire to assess smartphone addiction. This addiction appears to be strongly linked to anxiety, depression and impulsivity. The strong association between smartphone addiction and Internet addiction suggests that smartphone addiction is one of the many forms of Internet addiction. In fact, smartphones may not be the object of the addiction but rather a medium facilitating Internet access as it makes it possible to connect anywhere anytime. This raises the issue of the potential role of smartphones in speeding up and facilitating the development of Internet addiction.

[Psychopathology in online pathological gamblers: a preliminary study]. / Psychopathologie des joueurs pathologiques en ligne : une étude préliminaire.

INTRODUCTION: The rapidly expanding gambling offline and online have resulted in an increasing number of gamblers and the problem is likely to get worse in the future. However, online pathological gambling is a not well known. This rapidly developing modality of gambling, which requires to be studied, notably in its links with regular pathological gambling and Internet addiction. Depression and personality disorders are known to be often associated with pathological gambling. Personality disorders have an influence on pathological gambling, increasing its severity. Online gamblers seem to have a particular personality profile, compared to offline gamblers, and could present different personality disorders. Depression is a common comorbidity among online gamblers, as well as offline gamblers. Both types of gamblers have personality disorders, but the nature of these disorders differs: prevalency of personality disorders of cluster B (dramatic, emotional or erratic disorders) is more important in offline gamblers, whereas cluster C (anxious or fearful disorders) is more present in online pathological gamblers. In France, few studies have specifically examined this subject. AIMS: The objective of the study is to evaluate scores on depression, personality disorders and internet addiction in online pathological gamblers. METHOD: The South Oaks Gambling Screen (SOGS) is used to assess pathological gambling, Beck's Depression Inventory (BDI) to measure depression, the Personality Disorders Questionnaire (PDQ 4) to assess personality disorders and the Internet Addiction Test (IAT) to assess internet addiction. Participants completed the self-report scales. Questionnaires were strictly confidential. POPULATION: The participants were recruited in gambling places (cafés) and Internet forums. Two groups of pathological gamblers were formed: online gamblers (N=15) and offline gamblers (N=15). Participants gave their informed consent. Participation was voluntary and anonymous and no payment was made. ANALYSIS OF THE DATA: The data collection was carried out with an anonymous file and then placed in a data bank. The statistical analysis was carried out using traditional techniques: averages, frequency, standard deviations. Differences among groups were tested using the t-test. RESULTS: The results showed that the majority of subjects met diagnostic criteria for at least one personality disorder. The majority of pathological online gamblers evidenced personality of cluster C grouping avoidant, dependant and obsessive-compulsive personalities. Personality disorders differ according to the type of gambling: offline gamblers have more disorders of cluster B, while online gamblers have more disorders of cluster C. Some personality disorders, in particular borderline and narcissistic personality disorders, are often associated with pathological gambling and seem to have an increasing effect on depression and pathological gambling's intensity. Pathological gambling is strongly correlated to depression. Online pathological gambling, Internet addiction and offline pathological gambling appear to be strongly correlated. DISCUSSION/CONCLUSION: This study opens new perspectives of questioning and research, in particular for existing links between online and offline pathological gambling and internet addiction, and in existent differences between online and offline pathological gamblers. Online pathological gambling shares common characteristics with pathological gambling and Internet addiction, without being able to be assimilated with one or the other. This type of gambling, therefore, requires to be studied to adapt the actions of prevention and treatment intended for online pathological gamblers.

[How to treat a thyroid adenocarcinoma inside a branchial cyst]. / Conduite à tenir devant la découverte d'un adénocarcinome thyroïdien dans un kyste branchial.

The authors reported three cases of branchial cycts containing a thyroid adenocarcinoma. This rare condition imposed a search for the primary tumor. All complementary investigations remained negative as in the few cases reported in the medical literature. A loboisthmectomy for one and a total thyroidectomy for the two others, with cervical recurential neck dissection for all was carried out. Histological examination of the operative specimen after total blocking in paraffin helped discover microscopic foci of papillary carcinoma in the thyroid gland. These data justified this therapeutic attitude because the nature of the adenocarcinoma found in the branchial cyst is likely to be metastatic.

[Conditions of the remaining thyroid tissue after partial thyroidectomy]. / Devenir du tissu thyroïdien après thyroïdectomie partielle.

The authors have realized a retrospective study about 246 patients who underwent partial thyroidectomy for a benign nodule or goiter between 1982 and 1991. Recurrence was analized with the method of Kaplan-Meier and concerned 11% of the patients at 3 years and 30% at 8 years. The statistical analysis showed that only patients with postoperative hormonal treatment were at risk of recurrence. This treatment was not randomized. Other studied factors (sex, age, type of surgery, pathological results, TSH level) are not correlated with recurrence. Surgical management is discussed.

[Endonasal ethmoidectomy in naso-sinusal polyposis. Results in 110 surgically treated patients]. / L'ethmoïdectomie endonasale dans la polypose naso-sinusienne. Résultats à propos de 110 patients opérés.

We assessed retrospectively functional and endoscopic results obtained in 110 patients who underwent endonasal ethmoidectomy (n = 218). The patients were divided into 3 groups according to associated pathology (polyposis alone, asthma without intolerance to aspirin, Widal's disease) and outcome was evaluated after a mean 19.5 month follow-up. Function was improved in 88% of the patients. Endoscopic recurrence was seen in 40% of the patients including 10% with major polyposis. Oedema of the mucose remained in 20% of the patients and the mucosa was normal in 40%. Improvement in patients with Widal's disease was the least favourable among the three groups and was best in those with asthma and no intolerance to aspirin. Post-operative complications occurred in 12.6% of the patients and were severe in 0.9%. These satisfactory results, both in terms of function and the low rate of complications, suggest that the current medicosurgical management should be continued with particular attention to the rate of endoscopic recurrence.

Study of the efficacy and safety of ciprofloxacin in the treatment of chronic sinusitis.

Over a 12-month period, 56 patients with acute exacerbations of chronic sinusitis were included in this study. The mean age of the patients was 48.6 +/- 10.1 years. The period between the onset of sinus symptoms and inclusion in the study was 10.1 +/- 12.1 years and the exacerbation had lasted 2.4 +/- 4.4 months. Patients were given 500 mg ciprofloxacin twice daily for 9 days. Bacteriological specimens taken at inclusion were positive in 53.6% of cases, 25 Gram-positive and 16 Gram-negative pathogens being isolated. At the end of the treatment, rhinorrhoea, which was the main criterion for evaluation of the efficacy of treatment, had disappeared in 46/54 (85%) patients who were examined. Of the 30 patients whose sinusitis was confirmed by bacteriological test, the bacteria were eradicated in 90% of cases. At the end of a 4-week follow-up period after the end of treatment, the clinical success rate was 74.5%, the partial success rate 21.2% and the failure rate 4.3%. There were no bacteriological recurrences. Ten adverse events were observed in seven patients and in four (7%) of these treatment had to be withdrawn. This study showed ciprofloxacin to be an effective and well tolerated treatment for exacerbations of chronic sinusitis treated in non-hospital practice.

Study of the efficacy and safety of ciprofloxacin in the treatment of chronic otitis.

Over a period of 18 months 76 patients presenting with acute exacerbations of chronic otitis were enrolled in this study. The mean age of the patients was 46.4 +/- 16.8 years, the interval between the onset of symptoms of otitis and enrollment in the study was 22.1 +/- 19.4 years and the infective episode had been developing for 36.4 +/- 72.4 days. The patients received either 500 or 750 mg ciprofloxacin twice daily for a period of 9 days with no topical antibiotic treatment. The bacteriological specimen taken at enrollment was positive in 93% of the patients and led to the isolation of 85 microorganisms, 65% of which were Pseudomonas aeruginosa, Staphylococcus aureus or Proteus mirabilis. At the end of the treatment period, discharge from the ears (the primary clinical evaluation criterion) had ceased in 44/69 (64%) patients examined. The clinical cure rate was 23/39 (59%) for patients treated with 500 mg ciprofloxacin twice daily and 21/30 (70%) for those treated with 750 mg twice daily (difference was not statistically significant). At the end of a 4-week post-treatment follow-up, the clinical relapse rate was 7%. There was no relapse in the patients with chronic otitis which had been bacteriologically documented. Eight adverse effects were observed in five patients and treatment had to be discontinued in one case. This study shows ciprofloxacin to be an effective and safe agent for use in the treatment of acute exacerbations of chronic otitis treated in general practice. In certain cases, however, additional treatment with a topical antibiotic may be desirable.

[Mycoses of the maxillary sinus. Apropos of 40 cases]. / Les mycoses du sinus maxillaire. A propos de 40 cas.

Between 1985 and 1992, 40 patients with mycosis of the maxillary sinus were treated in the department at Hôpital Saint Michel and of otolaryngology, head-neck surgery at Hôpital Saint Michel and their charts retrospectively analysed. The clinical signs, radiological findings and etiopathological hypothesis are described. The authors report their experience of functional endoscopic sinus surgery for treatment of mycosis of maxillary sinus. A high rate of postoperative successes, a low rate of complications, the recovery of a normal intrasinusal aerial flow and the easy endoscopic follow-up lead them to adverate the use FESS in primary treatment for mycosis of the maxillary sinus.

[Initial results of 132 ethmoidectomies by endonasal approach]. / Résultats préliminaires de 132 ethmoïdectomies par voie endonasale.

47 cases of nasal polyposis and 19 cases of suppurated ethmoiditis were treated by intranasal ethmoidectomy. Results were evaluated by functional signs and nasosinusal endoscopy. 15 patients, among nasal polyposis, suffered from corticodependent asthma and 5 from Widal's disease. 64 patients were regularly followed-up for 1 to 4 years. Results in polyposis, after two years, in 47% of cases no recurrence was noted, a minor recurrence in 40% of cases, and 13% of failures with predominant Widal's disease. These results with low percentage of complications have lead us to choose intranasal ethmoidectomy. In suppurated ethmoiditis, results are good in 90% of cases if follow up is regular.

[Conchal cartilaginous delta graft in secondary or post-traumatic rhinoplasties]. / Le greffon cartilagineux conchal "delta" dans les rhinoplasties secondaires ou post-traumatiques.

The authors study several cases of surgical revision in post-traumatic or secondary rhinoplasty. Cartilaginous grafts with temporal fascia are recommended. The removal of ear cartilage is performed via a posterior approach for the concha cartilage associated with a septum or an alar cartilage removal. They describe the delta graft associating a concha cartilage supported by a prop (auricular or septal) to repair a defect of the middle or lower third of the pyramid.

["Delta" cartilaginous graft in secondary or post traumatic rhinoplasty]. / Le greffon cartilagineux "Delta" dans la rhinoplastie secondaire ou post-traumatique.

The authors study some cases of surgical revision in post traumatic or secondary rhinoplasty. Cartilaginous grafts with temporal superficialis fascia are recommended. The removal of ear cartilage is used by a posterior approach for the concha cartilage associated with a septum or an alar cartilage removal. They describe the Delta graft associating a concha cartilage supported by a prop (auricular or septal) to repair a loss of substance from the middle or lower third of the nasal pyramid.

[Plunging and mediastinal goiters]. / Les goitres plongeants et médiastinaux.

Of 185 cases of substernal goitre operated upon between 1976 and 1985, four were patients with autonomous mediastinal goitre. Diagnosis was established from results of clinical examination, a scan of mediastinum and radiologie imaging with a cervical and mediastinal CT scan as the investigation of choice. Treatment is exclusively surgical because of the risk of mediastinal compression. Most cases in this series were operated upon through a purely cervical approach, but 22 patients required partial upper sternotomy combined with cervicotomy, this minimal approach route allowing very good exposure of upper mediastinum.

[Dental infections and sinusoscopy]. / Infections dentaires et sinuscopie.

Sinuscopy, a simple procedure which can be performed under local anesthesia, is of diagnostic interest when it elucidates certain doubtful radiological appearances. Biopsies under direct vision are possible. It is of therapeutic value in, for example, the marsupialisation of cysts and the extraction of intrasinus foreign bodies.

[Ethmoidal fibroma in an 18-month-old infant (author's transl)]. / Fibrome ethmoïdal chez un nourrisson de 18 mois.

A case of ethmoidal fibroma in an 18-month-old infant is reported, and nosological, histological, and pathogenic features of this rare affection discussed. Though similar in some respects to Jaffe Lichtensteins fibrous dysplasia in its localized form, it differs, in that it sometimes runs a rapid course and has a tendency to relapse.

[Value of manubriotomy in extensive thyroid surgery. 11 cases (author's transl)]. / Intérêt de la manubriotomie dans la chirurgie extensive du corps thyroïde. A propos de 11 cas.

Manubriotomy was performed in 11 cases of retrosternal goitre or extensive thyroid cancers. The advantages of this method, which is described in detail, are that sternotomy can be avoided in the majority of cases, and that the postopeuative period is particularly straightforward.