[Multiple digestive involvement in visceral leishmaniasis in a patient with HIV infection: favourable course with itraconazole]. / Atteinte digestive multiple au cours d'une leishmaniose viscérale chez un patient infecté par le VIH: évolution favorable sous itraconazole.

We report a case of visceral leishmaniasis due to Leishmania infantum in a 35 year-old patient with acquired immunodeficiency syndrome who complained of chronic diarrhea. Biopsy specimens of gastric and duodenal mucosa and bone marrow aspirate led to the diagnosis. Enterocytozoon bieneusi, fortuitously found in the duodenal mucosa, did not seem to be the causative agent of diarrhea in this case, but its association with visceral leishmaniasis is rare. A treatment with itraconazole brought about a sustained clinical remission.

[Age and fertility: value of endometrial co-cultures]. / Age et fertilité: apport des cocultures sur cellules endométriales.

Embryo coculture system may contribute to understand the mechanisms underlying the decrease of fertility with aging. We report here our experience of coculture on maternal endometrial cells and histology of endometrial biopsy in 90 patients with repeated failures of implantation. Histology dating failed to find any age related changes. In coculture system, it is obvious that embryo viability diminishes with aging, but for equal embryonic quality, the maternal age does not interfere significantly on pregnancy rate. Anyway the number of first trimester abortions seems higher in older women. Coculture system emphasizes the major role of oocyte aging in the decrease of fertility and may be useful to establish a prognostic in IVF for older patients.

Coculture of embryos on homologous endometrial cells in patients with repeated failures of implantation.

OBJECTIVE: To evaluate the value of coculture of embryos on endometrial cells in patients with repeated failures of implantation. DESIGN: A retrospective comparison of pregnancy rates between IVF-ET with coculture and standard culture methods. PATIENTS: Ninety patients with repeated failures of transfer (range 4 to 11) underwent IVF-ET for a variety of disorders. METHOD: Embryos were cocultured on homologous endometrial cells and transferred on day 4 after retrieval of oocytes. RESULTS: The overall pregnancy rate for these patients was 21% per transfer versus 8% in previous IVF-ET cycles. A higher percentage (28%) was obtained for women < 39 years of age or on transfer of at least one morula (32.5% pregnancy per transfer). CONCLUSION: Coculture of embryos on homologous endometrial cells is both safe and ethical. It appears to be a valuable approach for the selection of a good quality embryo before transfer. The technique should prove to be of benefit to patients with repeated failures of implantation and also may be of value for assessing the respective responsibility of endometrium and embryo in these repeated failures. However, the mechanisms underlying this improvement need to be determined to simplify the procedure.

[Frequency of germ isolation from urinary infections in community practice; their sensitivity to 7 antibiotics including a combination of amoxicillin and clavulanic acid. Evaluation on 1611 samples]. / Fréquence d'isolement des germes d'infection urinaire en pratique de ville; leur sensibilité à sept antibiotiques dont l'association amoxicilline-acide clavulanique. Bilan sur 1,611 prélèvements.

A multicenter study including 10 outpatient private laboratories (hospital laboratories excluded) was carried out in France. 1,611 urines samples from patients with UTI were collected during the forth trimester of 1987. The most frequently recovered pathogens were: E. coli (71%), Proteus mirabilis (9%), Staphylococcus coagulase (6%), Klebsiella (6%), Enterobacter (2%). Other sorts (Streptococcus D, Proteus sp, Pseudomonas aeruginosa, Enterobacter sp) were infrequent (less than 1%). The sensitivity of the aerobic Gram-negative bacteria to ampicillin, clavulanic acid-amoxicillin, cephalothin, gentamicin, pipemidic acid, norfloxacin and co-trimoxazole was tested.

[Peritoneal gliomatosis associated with a mature teratoma of the ovary]. / Gliomatose péritonéale associée à un tératome mature de l'ovaire.

Peritoneal or/and omental implants composed of mature glial tissue is a rare complication of ovarian teratomas. A few cases have been previously reported, and one more case is described. The glial nature of the implants is proved by the presence of glial fibrillary acidic protein. The previous reports of long survival indicate that occurrence of this peritoneal gliomatosis does not alter the prognosis and that therapy directed at the peritoneal implants of mature glia is not required for cure.