ABSTRACT
Authors study retrospectively 81 cases of isolated recent (less than three months) knee traumas. These include clinical aspects, NMR, arthroscopy. Clinical examinations have been graded: 1. possible lesion; 2. likely lesions; 3. confirmed lesions. Clinical examinations and NMR results are compared to arthroscopy considered as reference. Clinical examination of acute traumatic knee is essential. Nevertheless, its value for detecting precise lesions is poor, except for knee locking well correlated with meniscal tears. Results show that NMR provide better results than clinical examination. NMR is reliable for detecting tears of posterior cruciate ligament, tears of posterior horn of menisci (sensibility: 93%; specificity: 80%). Its results are less effective for appreciation of lesion of anterior cruciate ligament (sensibility: 88%; specificity: 78%) because of partial tears and functional but not morphologic damage. It is the only method able to evidence osteochondral injuries and soft-tissues associated lesions in traumatic knees. Emergency NMR scans show results no differences in results compared with routine examinations. However, one should keep in mind that negative NMR cannot exclude small cartilaginous lesions and partial tears of anterior cruciate ligament. According to these results and the known qualities of NMR (non invasive), we propose that this type of investigation should be more largely included in diagnostic attitude for acute injured knee. Emergency diagnostic arthroscopy could be efficiently replaced by NMR knee examination.
Subject(s)
Arthroscopy/methods , Knee Injuries/diagnosis , Magnetic Resonance Imaging/methods , Acute Disease , Adolescent , Adult , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
One-hundred and four records of ambulatory deep venous thrombosis were studied retrospectively to determine the usefulness of an aetiological evaluation based on a rational approach. Among these 104 patients, 27 were known to have a cancer at the time of admission, and 77 had a presumably idiopathic deep venous thrombosis. The discovery of 10 cancers in the second group (13 percent) confirmed that the aetiological research was useful. Statistical analysis of the two populations and the different parameters of the thrombus and its course failed to show any significant difference in the patients whose cancer was revealed. The aetiological evaluation pointing to the diagnosis was always simple and not very costly; it consisted of careful physical examination with vaginal and/or rectal palpation, standard laboratory tests, X-ray films of the chest and abdomino-pelvic ultrasonography. Although these cancers were at an advanced stage when discovered, the aetiological research was justified by the finding of a few tumours amenable to curative surgical treatment.
Subject(s)
Bronchial Neoplasms/complications , Kidney Neoplasms/complications , Ovarian Neoplasms/complications , Prostatic Neoplasms/complications , Thrombophlebitis/etiology , Adult , Aged , Aged, 80 and over , Bronchial Neoplasms/diagnosis , Female , Humans , Kidney Neoplasms/diagnosis , Male , Middle Aged , Ovarian Neoplasms/diagnosis , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/diagnosis , Prostatic Neoplasms/diagnosis , Retrospective Studies , Thrombolytic Therapy , Thrombophlebitis/drug therapy , Thrombophlebitis/surgeryABSTRACT
Authors study retrospectively 81 cases of isolated recent (less than three months) knee traumas. These include clinical aspects, NMR, arthroscopy. Clinical examinations have been graded: 1. possible lesion; 2. likely lesions; 3. confirmed lesions. Clinical examinations and NMR results are compared to arthroscopy considered as reference. Clinical examination of acute traumatic knee is essential. Nevertheless, its value for detecting precise lesions is poor, except for knee locking well correlated with meniscal tears. Results show that NMR provide better results than clinical examination. NMR is reliable for detecting tears of posterior cruciate ligament, tears of posterior horn of menisci (sensibility: 93%; specificity: 80%). Its results are less effective for appreciation of lesion of anterior cruciate ligament (sensibility: 88%; specificity: 78%) because of partial tears and functional but not morphologic damage. It is the only method able to evidence osteochondral injuries and soft-tissues associated lesions in traumatic knees. Emergency NMR scans show results no differences in results compared with routine examinations. However, one should keep in mind that negative NMR cannot exclude small cartilaginous lesions and partial tears of anterior cruciate ligament. According to these results and the known qualities of NMR (non invasive), we propose that this type of investigation should be more largely included in diagnostic attitude for acute injured knee. Emergency diagnostic arthroscopy could be efficiently replaced by NMR knee examination.
Subject(s)
Knee Injuries/diagnosis , Acute Disease , Adolescent , Adult , Arthroscopy , Evaluation Studies as Topic , Female , Humans , Knee Injuries/diagnostic imaging , Magnetic Resonance Imaging , Male , Middle Aged , Radiography , Retrospective StudiesABSTRACT
A malaria investigation in the 1970-1986 period in French Guiana shows an increased plasmodium index (4.6%) when compared with the data of the 1970-1979 decade (2.7%), an incidence rate of 8.6 per 1,000 inhabitants (against 6.4 previously) and always a high frequency of P. falciparum (85%). The principal vector, A. darlingi, still remains sensitive to DDT but the authors recommend an updating of the anti-vectorial program control. A longitudinal serologic survey, on the school children during two years, shows the epidemiologic value of an immunological index. Its permits to precise the annual dynamic of malaria transmission and to distinguish in French Guiana three areas: a forest area with apparently permanent transmission, an hypo-endemic area with episodic transmission and a sporadic transmission area.
Subject(s)
Malaria/epidemiology , Animals , Anopheles/parasitology , Antibodies, Protozoan/isolation & purification , Child , Demography , Female , French Guiana/epidemiology , Humans , Insect Control , Insect Vectors , Longitudinal Studies , Malaria/prevention & control , Male , Plasmodium falciparum/immunology , Plasmodium falciparum/isolation & purificationSubject(s)
Climate , Tuberculosis, Pulmonary/epidemiology , Cote d'Ivoire , Data Collection , Female , Humans , Male , Risk FactorsABSTRACT
The in vitro susceptibility of various Plasmodium falciparum isolates obtained from patients infected in French Guiana was tested in a semi-microtest, using four antimalarial drugs. 90.6% of 32 isolates were resistant to chloroquine, 40% to amodiaquine and 17% to quinine. All the 17 isolates were susceptible to mefloquine.