[Scaphocapitate arthrodesis for chronic scapholunate instability: a retrospective study of 13 cases]. / Etude rétrospective de 13 arthrodèses scaphocapitatum pour instabilité scapholunaire chronique.

The management of chronic instability of the scapholunate joint is controversial. We have opted for scaphocapitate arthrodesis in such cases. The aim of this study was to analyse the clinical and radiological results of this procedure. Between 1997 and 2001, 13 scaphocapitate arthrodesis were performed for this indication. Eleven using two screws, one using a single screw plus a staple, and one using a single staple alone. The average age of the patients was 40 years. There were 8 sport accidents and 5 work accidents. The average follow-up was 26 months. We analysed the functional results and measured the height of the carpus and the radio-lunar angle radiographically. We noticed a mobility loss of between 20 and 40%, especially for radial tilt and flexion. The grip strength was improved. All the patients except one have some residual pain. We noted three non-unions which required revision with eventual final consolidation. The height of the carpus was improved. The average radio-lunar angle at follow-up was 16 degrees. Only one wrist remained in DISI. The mobility of the wrist was decreased by this procedure. In all these cases the dorsal approach to the wrist which we employed was bound to decrease the mobility. The radial tilt was decreased due to the partial arthrodesis. This procedure restore the height of the carpus and partially corrects the DISI. As we were not able to obtain a pain free wrist through our procedure, we raise the question as to whether a total neurectomy of the wrist should be performed at the same time.

Randomised placebo-controlled comparison of ivermectin and albendazole alone and in combination for Wuchereria bancrofti microfilaraemia in Haitian children.

BACKGROUND: Lymphatic filariasis and intestinal helminth infections are important disorders in tropical areas. Periodic treatment with albendazole is now used in many school-based intestinal helminth-control programmes. However, few such programmes exist for lymphatic filariasis, despite evidence that single-dose treatment with ivermectin can greatly reduce the concentration of Wuchereria bancrofti microfilariae in the blood for months to years. We aimed to assess the potential for school-based control of lymphatic filariasis by investigating the efficacy and tolerability or combined ivermectin and albendazole in Haitian schoolchildren. METHODS: In January, 1996, we collected 832 20 microL capillary blood samples for inclusion in a randomised controlled study from children aged 5-11 years, and examined them by microscopy for W bancrofti microfilariae. Infected children were randomly assigned treatment with placebo (n = 29), a single 200-400 micrograms/kg dose of ivermectin (mean, 273 micrograms/kg, n = 28), 400 mg albendazole (n = 29), or a combination of 200-400 micrograms/kg ivermectin and 400 mg albendazole (n = 24). Children with high concentrations of microfilariae in the blood were admitted to hospital and adverse reactions were monitored for 3-5 days, otherwise children were examined at school or during a visit to their home. 4 months after treatment, we examined blood samples again for microfilariae. FINDINGS: 113 microfilaraemic children were enrolled (mean age 7.8 years). 4 months after treatment, the proportion of children who remained positive for microfilariae was significantly lower in the ivermectin plus albendazole group (four [17%]), but there were no significant changes in the other three groups (20 [69%] placebo, 22 [76%] albendazole alone, 17 [61%] ivermectin alone remained positive; p = 0.004). Geometric mean microfilarial concentration decreased from 9.3 to 5.3 per 20 microL blood among children who received placebo; from 15.5 to 1.5 per 20 microL blood among those who received ivermectin only (p = 0.032); from 14.1 to 5.1 per 20 microL blood among those who received albendazole alone; and from 13.7 to 0.3 per 20 microL blood among those who received both ivermectin and albendazole (p = 0.0001). Systemic adverse reactions did not differ significantly between children who received ivermectin alone and those who were treated with ivermectin and albendazole [corrected]. INTERPRETATION: For children with W bancrofti microfilaraemia, combined treatment with ivermectin and albendazole was more effective than treatment with ivermectin only, with no measurable increase in severity of adverse reactions.

[Mycoses of the maxillary sinus. Apropos of 40 cases]. / Les mycoses du sinus maxillaire. A propos de 40 cas.

Between 1985 and 1992, 40 patients with mycosis of the maxillary sinus were treated in the department at Hôpital Saint Michel and of otolaryngology, head-neck surgery at Hôpital Saint Michel and their charts retrospectively analysed. The clinical signs, radiological findings and etiopathological hypothesis are described. The authors report their experience of functional endoscopic sinus surgery for treatment of mycosis of maxillary sinus. A high rate of postoperative successes, a low rate of complications, the recovery of a normal intrasinusal aerial flow and the easy endoscopic follow-up lead them to adverate the use FESS in primary treatment for mycosis of the maxillary sinus.

[Analysis of 830 case histories of male sterility of which 282 are usable. Results of our diagnostic investigations and therapeutic procedures]. / Analyse de 830 dossiers de stérilité masculine dont 282 utilisables. Résultats de nos investigations diagnostiques et de nos actes thérapeutiques.

Overall results are given of the investigation and treatment of 282 cases of male sterility: 245 cases of secretory and 37 of excretory sterility; 126 cases in which treatment produced no change, 110 cases showing biological improvement and 45 cases in which pregnancy occurred; 128 of the 282 men had varicoceles. There were three groups of patients; 1) Those with azoospermia: 59 cases, predominantly with excretory problems, bilateral atrophy and chromosomal anomalies: of these, eight showed an improvement, of which two resulted in pregnancy; 2) Those with oligo-asthenospermia: 110 cases, with predominantly solitary varicoceles, intoxications and unknown causes: 66 per 100 showed improvement, and in 23 of these cases pregnancy resulted; 3) Those with varicoceles associated with another cause, predominantly unilateral atrophy and intoxications: 62.8 percent showed biological improvement, and 12 of these cases resulted in pregnancy. Also mentioned is the group of patients with solitary asthenospermia; solitary oligospermia and hyperzoospermia of more than 200 million per ml. Varicocele is the predominant pathology in these three groups.