Large number of imported chikungunya cases in mainland France, 2014: a challenge for surveillance and response.

During the summer of 2014, all the pre-requisites for autochthonous transmission of chikungunya virus are present in southern France: a competent vector, Aedes albopictus, and a large number of travellers returning from the French Caribbean islands where an outbreak is occurring. We describe the system implemented for the surveillance of chikungunya and dengue in mainland France. From 2 May to 4 July 2014, there were 126 laboratory-confirmed imported chikungunya cases in mainland France.

Autochthonous case of dengue in France, October 2013.

In October 2013, autochthonous dengue fever was diagnosed in a laboratory technician in Bouches-du-Rhone, southern France, a department colonised by Aedes albopictus since 2010. After ruling out occupational contamination, we identified the likely chain of local vector-borne transmission from which the autochthonous case arose. Though limited, this second occurrence of autochthonous dengue transmission in France highlights that efforts should be continued to rapidly detect dengue virus introduction and prevent its further dissemination in France.

[Vertical dimension in the treatment of the edentulous patient]. / Dimensions verticales en prothèse complète.

Determining and recording appropriate occlusal vertical dimension (OVD) in the treatment of the edentulous patient is an important but critical procedure in practice. Incorrect determination of the OVD may result in failure of complete denture treatment. Many methods have been advocated to determine the vertical dimension in edentulous patients. However, there is no single precise scientific method for determining the correct OVD. These methods include the use of physiologic rest position, swallowing, phonetic, aesthetic, facial measurements. A combination of some of them is recommended for a simplified clinical determination. Moreover, the application of several accepted tests is advocated to verify the established OVD.

[News on the presence of the tiger mosquito Aedes albopictus in metropolitan France]. / Actualités 2008 sur la présence du moustique tigre Aedes albopictus en France métropolitaine.

Aedes albopictus (Tiger mosquito) lives mostly in urban areas. The females lay their eggs in containers close to the stagnant water. Aedes albopictus is spreading worldwide, helped by international transports of tires. In metropolitan France, it has settled down in the French Riviera since 2004, in Corsica since 2006. It is also present in other Mediterranean countries like Italy and Spain. Since Italian outbreak in summer 2007, the risk to acquire an autochthonous chikungunya or dengue diseases in France is high. To limit that risk, the French Health Ministry elaborated in 2006, a national programme. This plan includes preventive actions for patients suspected of chikungunya or dengue after having come back from a tropical area.

Report on the determination of occlusal vertical dimension and centric relation using swallowing in edentulous patients.

When constructing a complete denture, the correct vertical dimension of occlusion (VDO) and centric relation (CR) can be difficult to determine. The aim of this study was to compare the swallowing technique used to determine the maxillomandibular relationship with a conventional technique. Fifteen edentulous patients were selected, each having a complete denture. The VDO and CR were assessed using acrylic base plates and a Boley gauge. First, the VDO was established by means of the vertical dimension of rest (VDR) and interocclusal rest space, and the CR was obtained by mandibular manipulation. Secondly, the VDO and the antero-posterior mandibular position were determined using swallowing. All measurements were repeated three times and the average was calculated. The results showed that (i). the VDO determined by means of the swallowing method was reproducible and significantly higher than the one established from the VDR (P < 0.01), and (ii). the swallowing position was located 2 mm anterior to CR (P < 0.01) and was moderately reproducible. This study suggests that swallowing can be used to determine the vertical position but no as a reference position in the sagittal plane.

[A rare cause of postpartum hemorrhage: a genital thrombus]. / Une cause rare d'hémorragie du post-partum: le thrombus génital.

Puerperal hematoma is a grave but fortunately rare hemorrhagic post-partum complication (occurring in less than 1:1000 deliveries). The hematoma arises due to detachment of para-vaginal conjunctive tissue. In this type of tissue, no natural hemostasis take place and the hematoma may spread into the retroperitoneal cavity. The different risk factors include primiparity, instrumental extraction of the foetus, pre-eclampsia, twin pregnancy and the presence of vulvo-vaginal varicose veins. External bleeding may not always be evident and other clinical symptoms may be delayed. Despite this, rapid course may still occur with drastic consequences. When a case is referred, an examination of the vulvo-vaginal region is mandatory, resuscitation and surgery performed immediately. If this fails angiographic embolization should be carried out. The prognostic outcome of this rare case of post-partum hemorrhagia is highly dependent on early diagnosis and rapid treatment involving close cooperation between obstetricians and anesthetists, and also of rapid embolization to prevent possible intractable hematomas.

[Obstetrical epidural analgesia: an epidemiological in Bourgogne and Franche-Comté 1993]. / Analgésie péridurale obstétricale: étude épidémiologique en 1993 en Bourgogne et en Franche-Comté.

Many publications report the number of epidural analgesias carried out for the last years in English-speaking countries. On the other hand, very little information exists about the incidence of obstetrical epidural analgesia performed in South and Central Europe, particularly in France. A retrospective study within the regions of Bourgogne and Franche-Comté was carried out for the year 1993 firstly, to determine the number of obstetrical epidural analgesias performed and the drugs used; and secondly, to describe the organization and the problems encountered. The result of this study leads to one major question: what is the best type of organization in order to guarantee the highest safety, given the increasing demand for epidural analgesia in obstetrics?

[Angioneurotic edema and anesthesia: preparation and perioperative monitoring]. / Oedème angioneurotique et anesthésie: préparation et surveillance périopératoire.

Hereditary angioneurotic oedema is an autosomal dominant disease associated with serum deficiency of functional C1-inhibitor. It is characterized by periodic swelling of subcutaneous tissues, abdominal viscera and upper airways. Lethal acute episodes of oedema can occur during anaesthesia and surgery. It is essential to prepare such patients before surgery. This article describes three cases (kidney transplantation, caesarean section, normal delivery) and the various preventive measures used to avoid acute episodes during anaesthesia and surgery. Antibrinolytic agents, androgens, fresh frozen plasma, C1-inhibitor concentrate can be administered. Their various indications are discussed.

[Study of the effect of procyanidole oligomers on cultured mesenchymatous cells. III. Size and form of cells and nuclei. Quantitative morphologic study]. / Etude de l'action des oligomères procyanidoliques sur des cellules mésenchymateuses en culture. III. Taille et forme des cellules et de leurs noyaux. Etude par morphologie quantitative.

The effect of procyanidole oligomers (PCOs) on the morphology of cultured human skin fibroblasts (FB) and swine aorta smooth muscle cells (SMC) was studied. Exposure to PCOs induced dose-dependent changes in the size, shape and arrangement of cultured fibroblasts. Smooth muscle cells did not exhibit similar changes. These findings demonstrate that procyanidole oligomers interact with fibroblasts membrane and cytoskeletal constituents. With smooth muscle cells the main site of action of procyanidole oligomers may be the basement membrane surrounding the cells, which is lacking in fibroblasts. Thus, in addition to their action on extracellular matrix constituents, i.e., collagen and elastin fibers, procyanidole oligomers affect structural components of cells, i.e., the cell membrane and cytoskeleton. This twofold action of procyanidole oligomers on mesenchymatous cells and their extracellular matrix may be a significant component of the pharmacologic action of procyanidole oligomers.

[Prognostic evaluation of severe head injuries in children]. / Evaluation pronostique des traumatismes crâniens graves chez l'enfant.

In 34 children overcoming a severe head injury (coma greater than 1 d, mean: 10 d), the follow-up (mean: 25 m) has been correlated with several data. 1) The quality of life, according to a 3 grade-score, is mostly dependent upon the degree of neuropsychological sequelae. By decreasing frequency were noted disturbances of: memory, intelligence (the most significantly correlated with the quality of life), attention, rapidity of performances, behaviour, visuoconstructive activities. Most often several disturbances were associated, but without systematization. 2) Correlations between general outcome and early findings: a coma greater than 10 d, a subdural collection on the CT scan at 2-6 weeks have a pejorative meaning. Age does not appear to be relevant. 3) In a sequential study of neuropsychological functions, an early evaluation is poorly predictive, except in case of rapid normalization. Evaluation at 6 months gives a good picture of the outcome. Sectorial improvements can occur beyond the 1st year but do not appear to modify dramatically the general outcome.

[The effect of procyanidolic oligomers on vascular permeability. A study using quantitative morphology]. / Action des oligomères procyanidoliques sur la perméabilité de la paroi vasculaire. Etude par morphologie quantitative.

In normal conditions vascular permeability is precisely regulated by mechanisms which involve among others the macromolecules of extracellular matrix of the vascular wall. Permeability for a given substance will vary according to the anatomical localisation of the vessel determining also its structure and composition. In some pathological conditions, such as inflammation or diabetes, permeability can be abnormally increased. Increased permeability can be reproduced by i.v. collagenase injection. This permeability increase can be quantified by image analysis using appropriate tracers such as FITC-dextrans or horse-radish peroxidase, on histological sections from control and collagenase treated rats, pretreated or not with procyanidolic oligomers (PCO). We studied cerebral capillaries, aorta and cardiac muscle capillaries. It could be shown that previous treatment of animals with procyanidolic oligomers prevented the permeability increase produced by collagenase injection.

[Congenital hydrocephalus after intraventricular hemorrhage in utero]. / Hydrocéphalie congénitale après hémorragie intra-ventriculaire in utero.

A case of congenital hydrocephalus following a foetal intraventricular bleeding is reported. The diagnosis was made at 36th week by ultrasonography. Whether this mechanism could be involved in some cases of "idiopathic" congenital hydrocephalus is discussed.

Biochemical study of the Feline Herpesvirus 1. Identification of glycoproteins by affinity.

Feline Viral Rhinotracheitis herpesvirus (Feline Herpesvirus 1; FHV-1) was purified by rate zonal isopycnic centrifugation. Viral nucleocapsids were isolated from the nuclei and purified. Analysis of the purified and radiolabelled viral polypeptides and glycoproteins by gradient SDS polyacrylamide gel electrophoresis revealed that 23 viral proteins and 6 glycoproteins were present in the whole virus particle. Tween 80-diethylether treatment removed the major glycoproteins. FHV-1 viral glycoproteins were detected using [14C] glucosamine and a lectin binding procedure. The fluorescein isothiocyanate-Concanavalin A (FITC-Con A) specificity was checked by trials on other viruses whose glycoproteins had already been described. The FITC-Con A allows a very simplified procedure for glycoprotein determination after slab acrylamide gel electrophoresis and can be used prior to Coomassie blue staining of proteins.