[Hemophagocytic syndrome due to Herpes simplex virus after hysteroscopy]. / Syndrome d'activation macrophagique à Herpes simplex virus après hystéroscopie.

Hemophagocytic syndrome is an uncommon but life-threatening complication of Herpes simplex virus type 1 or 2 infection. Diagnosis is difficult to establish given the low specificity of clinical and biological signs.

[Acute psychosis in Réunion Island. Retrospective study performed on the 4th sector of psychiatry (west region) on the year 1997]. / Les psychoses aiguës à la Réunion. Etude rétrospective réalisée sur le secteur IV de psychiatrie (région ouest) sur l'année 1997.

A retrospective study in the West psychiatry service in Reunion island (an area with 85,000 inhabitants) includes 19 files for patients hospitalized for the first time during the year 1997 with a diagnosis of acute psychosis. It excludes the troubles linked to the acute or chronic use of alcohol and the mental aberrations. This study regroups a young population, basically male and more often disadvantaged. The deliriums are stereotyped, essentially borrowed from the local culture. Two important points become visible: in more then half of the cases, drug taking (polyintoxication systematically associating cannabis) is evoked as the main etiologic factor. The prognosis in the short term of those acute psychosis is good, with a rapid regression of symptomatology under neuroleptic treatment. The evolution in the long term must be more moderated: four patients will develop a chronic psychosis; whatever the situation (taking drug or not), this acute psychotic episodes are revealing of an underlying chronic psychosis in nine cases out of nineteen. This fact underlines the interest of following those patients regularly to obtain a withdrawal with the addicted persons (risk of acute psychotic relapse) and of anticipating a chronic psychotic evolution.

[Congenital left ventricular aneurysms and diverticula. Two case reports]. / Anévrysmes et diverticules congénitaux du ventricule gauche. A propos de deux observations.

The authors report the cases of two young adults (25 and 27 years) presenting with congenital left ventricular aneurysm or diverticulum with healthy coronary arteries. This saccular evagination of the ventricular wall is rare. The authors describe a classification distinguishing muscular (contractile) diverticula, composed of the three cardiac tunics, fibrous diverticula and finally aneurysms with a dyskinetic wall. Although the limits of this classification are sometimes poorly defined, it presents a prognostic value, because it appears logical to propose nonsurgical management in the context of muscular diverticula and it seems legitimate to operate on fibrous diverticula and aneurysms due to the risks of rupture, extension, thrombosis or arrhythmia.

Squamous cell carcinoma of the esophagus. Treatment by combined vincristine-methotrexate plus folinic acid rescue and cisplatin before radiotherapy.

From January to November, 1981, 28 patients with unresectable squamous cell carcinoma of the esophagus were treated with two cycles of chemotherapy combining vincristine (V), methotrexate (M), folinic acid rescue, and cisplatin (P) on days 1 and 21. Split-course radiation therapy was delivered thereafter from day 42 on. Hematologic, renal, and neurologic tolerance was acceptable, but most of the patients experienced nausea and vomiting. Results evolution at day 40 showed a 61% partial response (PR) rate and a 7% complete response (CR) rate. One month after the end of radiation therapy, 43% PR and 32% CR were obtained. Median response duration was 8 months. Median survival was 11.6 months for patients overall, yielding 12.9 months for responders and 5.9 months for nonresponders. Based on the response rate obtained with combined chemotherapy, a randomized trial of VMP initial chemotherapy is currently being undertaken by our cooperative group to study whether such an initial treatment could improve resectability and radiation-mediated local control along with survival rate.