[Imported malaria in children in 1999. Study of the Armand-Trousseau Hospital in Paris]. / Le paludisme d'importation de l'enfant en 1999. Etude parisienne à l'hôpital Armand-Trousseau.

METHODS: Eighty children were treated at the hospital Armand-Trousseau (Paris, France) for a malaria attack from 1999-01-01 to 2000-02-01. RESULTS: The parasites were: Plasmodium falciparum: 87.5%, Plasmodium malariae: 12.6%, Plasmodium ovale: 10%, Plasmodium vivax: 6.3%. Mean age was 8.1 years (range: three months to 15 y). The origin of patients was: West Africa for 60 children, Central Africa for ten children and Comores for seven. Sixty-six patients suffered from common malaria attack and seven children were admitted with a presentation of severe malaria. The severe attacks were cerebral malaria for six cases, associated with severe anemia in five cases; the 7th child had a respiratory distress (ARDS) and died. The other six cases were cured without sequelae. Relapses were observed for eight patients: one after a severe cerebral malaria, six after a common P. falciparum attack, one after a P. ovale attack. Parasitemia was higher than in preceding years (mean 2.9%) and more than 5% in 11 cases, but without clear link with severity. Treatment by halofantrine with a single cure was followed by five relapses. None of those children received an effective prophylaxis during and after travel (55/80 without any prophylaxis). CONCLUSION: These data emphasize the importance of a good appraisal of criteria of severe malaria and lead to advice hospitalization of children with malaria in temperate zone.

Hysterectomy for pregnancy termination and sterilization.

I have presented opposing views from the literature and my results in both the first and second trimester of pregnancy. I feel that those who already favor vaginal hysterectomy for sterilization alone would have their opinions reinforced by the additional benefit of pregnancy termination. I hope that those who oppose using vaginal hysterectomy for sterilization alone might be convinced that the added benefit of elective termination of pregnancy makes it acceptable, since a double benefit will be offered. Many gynecologists already teach this method as regards early pregnancy. Perhaps some will be convinced to terminate more advanced pregnancies in this manner.

Termination of pregnancy in the midtrimester using a new technic. Preliminary report.

This report is a preliminary one because the number of cases is small (30+) and follow-up is not adequate, either as to detail or time. However, the initial results and observations are so favorable that unless untoward complications arise, we predict that this procedure will supplant the other usual methods of midtrimester abortion. We have looked for but have not found any infections, hemorrhage, perforations, failure of the uterus to empty within a reasonable length of time or prolonged postoperative bleeding. The method herein proposed offers greater safety by creating fewer risks to the patient; her exposure to hazards is therefore diminished. Future pregnancies are safer because the birth canal has not been attenuated by rupture, near rupture, perforation or surgical scarring. It is our hope that others will try this technic to prove or disprove its efficacy.