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.

[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.

[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.

[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.

[Radiological examination of the eustachian tube. Radiomanometry technique (author's transl)]. / Etude radiographique de la trompe d'Eustache. Interêt de la radiomanométrie tubaire. Etude préliminaire.

Radiomanometry is a modified technique for visualisation of the auditory tube. The contrast material is injected through a perforated tympanic membrane with control of injection pressure. Three positions are recommended: sub-mento-vertical, Worms, and modified Stenvers. The normal aspect of the tube is described with variations. Some pathological obstructtions are demonstrated. However, it must be underlined that many tubes with abnormal manometric test were not abnormal at the radiological evaluation: fonctionnal aspect is more important than anatomical one in the inflammatory pathology of the tube.

[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?