[Food consumption of infants and young children in France in 1997]. / Consommation alimentaire des nourrissons et des enfants en bas âge en France en 1997.

BACKGROUND: In 1981 and 1989, two French nationwide food consumption surveys reported the dietary intakes of infants and toddlers. In 1997, another survey was conducted. POPULATION AND METHODS: Six-hundred and sixty, 1 to 30-month-old infants and children were recruited. Food records were completed by their parents during a 3-day period. Energy, proteins, carbohydrates, total lipids, minerals, vitamins, linoleic acid contents were calculated. Energy contribution of various food groups and the pattern of the distribution of the different meals were indicated. RESULTS: Between 1989 and 1997, the contribution of milk-based infant formulas increased at 4, 5, 7 and 8-9 months. From the age of 5 months, approximately 75% of the children had a protein intake twice as high as the official recommendations. Mean iron intakes were higher than those calculated in 1989 at the age of 7, 8-9 and 10-12 months. The average daily intake of linoleic acid was lower than the recommended daily allowance from the age of 6 months. CONCLUSION: Trends in dietary intakes between 1989 and 1997 indicated that the nutritional needs of French infants and toddlers are better covered as recommended by scientific committees. More effective efforts are needed for improvement of their nutritional status particularly for iron and essential fatty acids. For example, weaning foods should be introduced later and toddler's formulas should be used more systematically and longer.

Flexibility of scoliosis. What does it mean? Is this terminology appropriate?

This work is a critical analysis of the term "flexibility of scoliosis." The authors demonstrate that this measure includes two very different and noncorrelated phenomena: the collapse and the reducibility of the structural curve. In 228 paralytic curves, these two phenomena were quantified and correlated with different parameters of scoliosis: sex, stage of maturation, curve pattern, number of vertebrae in the curve, spinal and abdominal test values, and the scoliotic evolution rate. Reducibility can be predicted since it is an elasticity process. Collapse is more complex, but it is a prognostic factor for evolution and effectiveness of treatment. The preliminary results of a similar study of idiopathic scoliosis are the same.

Scoliosis and trunk muscles.

This study examines the role of muscular deficiencies in the origin and development of paralytic scoliosis. We studied spine films of 108 scoliotic curves of poliomyelitic children and results of muscle tests made during the growth phase. We investigated the relationship between spinal and abdominal muscle test values, determined 2 years after the child had experienced the acute phase of anterior polioimyelitis, and the convexity, evolution rate, effects of gravity, and reducibility of the scoliotic deformity. Although paralysis certainly is responsible for triggering scoliosis, it plays no role in determining convexity for thoracic and lumbar patterns, and has little bearing on thoracolumbar curves. It is not at all correlated with the evolution rate, reducibility, or degree of collapse with gravity. The general laws governing the evolution of scoliosis, whatever its origin, are outlined, and several possible pathogenic factors are suggested.

The mobile arm support.

The Mobile Arm Support, conceived and researched by Dr. Radulovic, is intended for the use of patients whose arm is afflicted. The support consists of a supporting harness, an articulated splint on which the arm is fixed and a pneumatic system of elevation that counterbalances the weight of the arm. Its originality lies in the use of a splint as a simple lever, supported by a spherical articulation, located as close as possible to the centre of the scapulohumeral joint and linking shoulder and arm movements. A clinical study involving 18 patients has shown that the support reduces pain, increases ranges of movement of the shoulder and elbow, and increases functional possibilities.

[The possibility of walking in the paralysed of the lower limbs (author's transl)]. / La marche chez les paralysés des membres inférieurs: ses indications et ses moyens.

The authors have studied the possibility of walking after rehabilitation and bracing in the paralysed of the lower limbs, it is variable with aetiological factors and age of patients. In children, walking after bracing is almost always indicated-it should be discussed case after case in adults. The authors analyse the role of different types of braces such as pneumatic braces and orthoptic systems using electrical stimulation. Some views on the future are exposed.

[The affected medullary segment in paraplegics. Relation to sexual function in men (author's transl)]. / Le segment médullaire lésionnel chez le paraplégique. Applications à la fonction génito-sexuelle chez l'homme.

The authors made a detailed clinical analysis of 119 stabilized total paraplegics in order to define, as precisely as possible, the limits of the medullary segment which, for each patient, had lost all its functional value. The relationships between the affected segments and the sexual capabilities of these patients show that the segment must: --exclude the sacral spinal cord if reflex erections are to occur; --underly Th. IX at least, or better still Th. XI, for psychogenic turgescence to appear; the efferent pathways seem therefore, to emerge from the cord quite close to the level which receives testicular afferent pathways; --underly or overly Th. XII, L I, and L II for at least the greater part, for emission of sperm to occur; a true abrupt ejaculation probably requires the complementary integrity of the sacral spinal cord.

[Longitudinal study of vital capacity during the growth of 69 poliomyelitics (author's transl)]. / Etude longitudinale de la capacité vitale au cours de la croissance chez 69 poliomyélitiques.

A longitudinal study of vital capacity (VC) during the growth of 69 children with poliomyelitis was made starting shortly after the end of the period of muscular recovery until they attained 17 years. VC was compared with two theoretical values (VCT). The beginning of puberty was determined by the acceleration of growth of total height and the appearance of pubic hair. Statistical analysis of VC/VCT between the beginning and the end of the study reveals that intercostal paralysis, costal deformities, dorsal scoliosis over 30 degrees and atelectasis were significantly more frequent among the 46 children with unfavourable evolution than among the 23 children with favourable evolution. Comparison of the VC/VCT means at different periods of growth reveals that the growth of VC in poliomyelitics does not undergo the same acceleration as that of height during the two years after the beginning of puberty. In normal subjects, this phenomen has not been clearly seen in cross sectional studies which do not take into account the stage of puberty.

[Late syringomyelic syndromes in paraplegics]. / Syndromes syringomyéliques tardifs chez les paraplégiques.

The authors have reviewed 35 cases in the literature and reported on 12 cases seen personally of late onset syringomyelia in paraplegics. Initial pain was found to be present in only slightly more than half the cases and an insidious onset particularly with sensory disturbance led sometimes to delayed recognition. In the fully developed case, it can closely simulate idiopathic syringomyelia with arthropathy but impairment of touch and proprioception sometimes occurs in addition. Neurosurgical treatment to the fluid-filled cavity, does not seem to modify obviously the spontaneous evolution of the condition. In 5 cases, the paraplegia was not of traumatic origin. Possible mechanisms are discussed.

[Paraplegia and bilharziasis. A propos of 4 cases (including 2 confirmed cases of bilharzial myelitis]. / Paraplégie et bilharziose. A propos de quatre observations (dont deux de myélite bilharzienne certaine).

Four observations of paraplegia of bilharzians are presented. In two of them the anatomical proof of medullar localization of parasitosis was obtained, once in vivo, only once after a post-mortem. Medical study enables us to spot 55 cases of bilharzian paraplegia, of which 25 sufficiently explicit on the clinical point of view, indicated medullar parasitosis. A parasitosis diagnosis must especially therefore be sought out with the greatest care so that the specific and remarkably active treatment may be started as soon as possible.

Pregnancy of the wife of a complete paraplegic by homologeous insemination after an intrathecal injection of neostigmine.

A case of successful pregnancy following artificial insemination following intrathecal neostigmine injection in the wife of a complete traumatic paraplegic (T7-T8 to T11-T12) is described.

[10 cases of giant lumbo-sacral neurinoma]. / Dix cas de neurinomes géants lombo-sacrés

Among giant tumours of the cauda equina, apart from ependymomas, neurinomas merit a special place. Depending on their site, they give rise to severe lumbar pain or root pain, with, almost constantly, aggravation during the night. X ray suggests the diagnosis when one finds displacement of the bone without inflammation, a regular bony defect, well-limited and asymmetric, and when the tumour is frequently prolonges in several directions across the bony orifices, sometimes giving a very large paravertebral mass which requires a double approach during surgery. The prognosis of isolated neurinomas is excellent, with disappearance of the pain immediately after operation, regression of the neurological signs or, at any rate, stabilisation when the latter are important. As far as the problem of spinal stability is concerned, this has been solved by sufficient spontaneous bony reconstruction.

[Para- and tetraplegia caused by decompression accident (deep sea diving). Study of 9 cases with more or less severe sequelae]. / Para et tétraplégies par accident de décompression (plongée sous-marine). Etude de 9 observations avec séquelles plus ou moins graves

The authors report 9 cases of para and tetraplegia due to decompression sickness following deep sea diving. Poor technique was the cause of 8 of these cases, but one remained totally unexplained. The sequelae were serious; 3 dorsal paraplegias, which were functionally complete, 4 incomplete tetraplegias giving rise to permanent disability. In 2 cases there remained some spasticity of the lower limbs, in some cases associated with genito-urinary disorders. The authors review recent physiopathological theories. -- Blood disturbances may be due to the presence of gas bubbles which aggress the organism and give rise to coagulation disorders. -- The formation of the bubbles may be the cause of the spinal lesions, e.g. liberation in situ, gas embolism; the bubbles may form in various parts of the circulation and may cross the pulmonary barrage. Bubbles probably form in the lung itself, in the pulmonary veins and in the aorta, including the spinal capillaries. There is some slowing of the circulation, secondary to increased pressure, and pulmonary stasis may also play a harmful role. Finally, the dorsal spinal segments, which are the most poorly vascularised, are particularly exposed. This corresponds to the clinical findings. As far as treatment is concerned, the authors emphasize that recompression with hyperbaric equipment, should be carried out as an emergency, especially in unconsciuos subjects, together with other appropriate treatment. Such facts are important now that deep sea diving is becoming more and more commonly practised.