[Skin tests in allergology: really so simple?]. / Tests cutanés en allergologie: si simple en apparence...

In allergology, skin tests (ST) are one of the main tools. Their simplicity, rapidity of the result, low cost, near absence of risk make them complements of choice to the patient history which remains the crucial step of the diagnosis. ST demonstrate in vivo the capacity of the cutaneous mast cells to potentially react to allergens. Their sensitivity is good, some precautions have to be taken into account (no antihistaminic drugs, quality of the extracts). Specificity is also good, but a positive test (which is suggestive of the presence of IgE) not always predicts clinical allergic manifestations. Knowledge of limits and pitfalls of ST is of major importance, especially when it comes to selecting extracts for specific immunotherapy and to investigate severe anaphylactic reactions to food or drugs.

[Periarteritis nodosa and hepatitis C: a fortuitous association?]. / Périartérite noueuse et hépatite C: association fortuite?

Polyarteritis nodosa is a vasculitis of unknown origin which can be rarely associated with hepatitis B. A exceptional clinical situation of a polyarteritis nodosa associated with hepatitis C is described. This case is also the occasion to review the clinical manifestations, the diagnostic strategy und the therapeutic options of this rare vasculitis.

[Pelvic and acetabular fractures, long term results, retrospective study from Cadolles from 1977 to 1997]. / Fractures du bassin et du cotyle, résultats à long terme, étude rétrospective du collectif des Cadolles de 1977 à 1997.

From 1977 to 1997, 51 unstable pelvic and/or acetabular fractures were operated in our institution. We could control 35 after a mean postoperative period of nearly six years. The outcome was analysed considering several factors: pain, neurological and genito-urinary problems, gait, social life, Xrays and clinical findings. Our results match well with those of other series. Different evaluation scores used in the literature are compared and discussed.

[Outcome of nonspecific right iliac fossa pain syndromes]. / Devenir des syndromes douloureux non spécifiques de la fosse iliaque droite.

One-third of all cases of abdominal pain and a quarter of cases of right iliac fossa pain urgently admitted to hospital leave hospital with no precise diagnosis. Based on a series of 400 patients hospitalised for right iliac fossa pain, comprising 107 cases with no identified aetiology, this prospective study was designed to assess the medium-term outcome of these patients, with or without surgical exploration. 67 cases were reviewed at five years. No major diagnosis was missed. Over this 5-year period, 30 patients (45%) experienced another episode of abdominal pain. Among the third of patients (21 cases, 31%) reviewed for another episode of right iliac fossa pain, 7 were readmitted to hospital, with 5 operations, for histologically confirmed acute appendicitis in 3 cases (5% of the series). The patient and his attending physician must be informed of the nonspecific diagnosis established during the first hospitalisation. There is no significant evidence to suggest a psychological component in the recurrent nature of the pain. Cancer must be formally excluded in patients over the age of 50. When surgical exploration is performed, nowadays by laparoscopy, appendicectomy is recommended. This procedure does not decrease the risk of recurrent pain, but confirms the real absence of histopathological abnormality and decreases the number of subsequent hospitalisations.