[A case report of frosted branch angiitis associated with aseptic meningitis in a young boy]. / Un cas d'angéite givrée associée à une méningite aseptique chez un jeune garçon.

We report on an 11-year-old boy with frosted branch angiitis in both eyes associated with aseptic meningitis. The patient presented after a severe decrease in vision in both eyes and a 40°C fever. The examination of the fundus of the eyes revealed a diffuse edema of the retina and diffuse bilateral vascular sheathing. The complementary examinations revealed aseptic meningitis. Neither infectious etiologies nor systemic diseases could be confirmed and an inflammatory digestive disease was suspected because of recent diarrhea events responsible for substantial weight loss. A systemic corticotherapy slowly improved the vision in both eyes. After 1 year of medication, visual recovery was full with no sequelae on fundus examination.

[External dacryocystorhinostomy under local anesthesia and sedation]. / Les dacryocystorhinostomies par voie externe sous anesthésie locale et sédation.

INTRODUCTION: External dacryocystorhinostomy (DCR) surgery is highly advantageous in that it can be performed under local anesthesia associated with sedation. We aimed at verifying the efficiency of the anesthesia, studying the general behavior of the patient and the quality of the surgery. PATIENTS AND METHODS: A prospective study of a local anesthetic protocol associated with sedation was conducted in our Oculoplastic Department on 34 patients (71.5+/-8.3 years of age) between may 2007 and march 2008. The anesthetic protocol consisted of blocking four nerves based on the analysis of the anatomy of facial innervation. The including criteria were patient antecedents such as arterial hypertension, cardiac or lung problems, diabetes, and no contraindications for local anesthesia. The hemodynamic constants, variability of the Ramsay score, and complications such as bleeding or pain were studied. The progress of the surgery was simultaneously evaluated by the patients, anesthesiologists, and surgeons. RESULTS: Both the hemodynamic constants and the Ramsay score remained stable intra- and postoperatively. In addition, the visual analog scale (VAS) scores remained low. Both surgeon and patient satisfaction was excellent (88.4 % of the patients declared that they were ready to choose the same anesthetic protocol if new surgery were to be performed). The surgery's success rate was 79.3 % (no watering at 3 months) versus 82 % for the patients operated under general anesthesia. CONCLUSION: The protocol of local anesthesia associated with sedation for external DCR is therefore safe and efficient.

[Sequelae and quality of life in young adult survivors of childhood cancer]. / Séquelles et qualité de vie chez de jeunes adultes survivants de cancers pédiatriques.

PURPOSE: The long-term survival rate of childhood cancer is around 70%, but cancer- and treatment-related sequelae and the risk of a second malignancy may impair the survivors' quality of life. METHODS: Fifty-four patients older than 18 years, treated for a cancer between 1988 and 1996, and considered as cured for at least 5 years, were asked to participate. Data on cancer, treatment and sequelae were extracted from the Rhône-Alpes childhood cancer registry and from the medical charts. Health-related quality of life was assessed with the SF-36 scale. Lifestyle, educational level, present occupation, subjective health, and worries were assessed with a detailed questionnaire. RESULTS: Forty-three young adult patients participated (16 female, 27 male, mean age 23 [range: 18-32]). Primary cancers were leukaemias (35%), lymphomas (19%), solid tumors (34%) and central nervous system tumors (12%). Nine percent of the subjects had received cranio-spinal radiotherapy, and 14% a total body irradiation followed by bone marrow transplantation. Two patients (5%) had developed a second malignancy, 30% have an endocrine insufficiency, 14% have neurological or psychological impairment, and 21% have orthopaedic sequelae. Health-related quality of life of the population as a whole, as assessed by SF-36, is close to normative data published for healthy population of that age. Female gender, certain types of cancer (neuroblastoma, bone tumors and carcinomas), and the presence of endocrine sequelae are predictors of a worse quality of life. Only 3 patients (7%) declared having had to shorten their education because of their cancer; 63% are currently employed, 25% are students or apprentices. Worries about fertility are often mentioned; half of the subjects declare having received no formal instruction about their medical follow-up in adult age. CONCLUSION: Although the quality of life of young adult survivors of childhood cancer as a whole does not seem very much altered, many of these survivors experience adverse sequelae warranting medical and psychological attention. Some of their preoccupations, such as worries about reproductive capacity and inheritability of their cancer, are often ignored.

[Elastosis perforans serpiginosa associated with Down's syndrome and sex-linked ichthyosis. Treatment with 13-cis-retinoic acid]. / Elastosis perforante serpiginosa asociada a síndrome de Down e ictiosis ligada al sexo. Tratamiento con ácido 13-cis retinoico.

We study here the case of a male patient aged 22 years with antecedents of Down syndrome and X-linked ichthyosis. The results obtained from the administration of 13-cis retinoic acid are commented upon. The association with other diseases and the treatment are also reviewed.