[PCR SSCP study of an echovirus 30 meningitis outbreak]. / Etude par PCR SSCP d'une épidémie de méningite à échovirus 30.

Between April and October 1997, 21 children of 4 days to 13 years old were admitted to the Pedatric Unit of Aulnay Sous Bois's Hospital for viral meningitidis. The number of white blood cells in the cerebrospinal fluid (CSF) was between 1 and 612 cells/mm3, with, on an average, 56% of segmented cells, 34% lymphocytes and 34% monocytes. Proteins and glucose of CSF were standard. One CSF was normal. Viral meningitidis was confirmed by viral culture of CSF onto MRC5. Enterovirus were identified by direct immunofluorescence (Monoclonal Mouse Anti-Enterovirus, Dako). Serotyping (Enterovirus antisera, Eurobio, Trousses 4) identified an echovirus 30 in all cases. A highly conserved 154 bp sequence at the 5'non-coding region was studied by reverse transcription-polymerase chain reaction (RT-PCR) followed by single-strand conformation polymorphism (SSCP) (GenPhor, Pharmacia) analysis. Two dominant SSCP patterns were observed: the first contained 4/21 strains and the other 10/21 strains. The SSCP patterns of the 7 other strains were different. These results show that 2 echovirus 30 dominant clones were responsible of viral meningitidis admitted to the Pediatric Unit of Aulnay Sous Bois's hospital, between april and october 1997. The PCR-SSCP of the 5'non-coding region of echovirus 30 is a convenient, simple, reproducible epidemiologic method and it's easily applicable in a general hospital.

Changes in umbilical artery, middle cerebral artery, and aorta blood flow Doppler waveform pulsatility indices after funisocentesis.

This study evaluates the effect of funisocentesis on umbilical artery, fetal cerebral artery, and aortic circulation. The pulsatility index in the umbilical artery, fetal middle cerebral artery, and descending aorta was measured by pulsed Doppler ultrasonography before and after 41 diagnostic funisocenteses. Percutaneous umbilical artery blood sampling was associated with a significant decrease in umbilical artery pulsatility index (mean -0.132, standard deviation 0.259, P = 0.002) and in middle cerebral artery pulsatility index (mean -0.143, standard deviation 0.260, P = 0.001). The decline in resistance to flow of the umbilical artery (r = 0.340, P = 0.029) and middle cerebral artery (r = 0.457, P = 0.002) was correlated with gestational age at sampling. These findings suggest that alterations in the waveforms from both the umbilical and the fetal cerebral circulations can be induced by fetal blood sampling.

[Diagnostic and prognostic importance of laboratory tests in malaria in airports. Study of six recent cases]. / Importance diagnostique et pronostique des examens de laboratoire au cours du paludisme des aéroports. Etude de six cas récents.

During the summer 1994, six cases of airport malaria occurred in France, near the Roissy-Charles-de-Gaulle airport. Due to Plasmodium falciparum, all cases underwent rapid and severe deterioration, and in one case, the patient died. The role of laboratory tests is essential to establish the diagnosis of persons who have never resided in the endemic malaria areas and follow up with the patients already under treatment to detect possible complications.

[Doppler velocimetry in the umbilical, middle cerebral and aortic arteries, before and after cordocentesis]. / Vélocimétries Doppler des artères ombilicales, cérébrales moyennes et aortiques, avant et après cordocentèse.

OBJECTIVE: Prospectively evaluate the effect of cordocentesis on the umbilical, fetal cerebral and aortic circulation. METHOD: Fetal blood was sampled for diagnostic purposes in 21 pregnant women at 21 to 38 weeks gestation. Ten patients undergoing amniocentesis served as controls. The resistance index (RI) in the umbilical and middle cerebral arteries and the mean blood velocity (Vm) in the descending aorta were measured with pulsed Doppler before and after blood sampling. Variations in umbilical and cerebral RI and in aortic Vm were recorded. RESULTS: There was a significant drop in both umbilical RI (mean +/- SD = -0.049 +/- 0.078; p = 0.009) and middle cerebral RI (-0.077 +/- 0.058; p < 0.0001) after cordocentesis. The drop in umbilical RI was greater when the second Doppler measurement was made early, when the blood was sampled transplacentally and in early gestational age. Reduction in fetal cerebral artery RI was also greater for transplacental puncture. The fetal descending aorta Vm did not change significantly after blood sampling. There were no variations in Doppler index before and after amniocentesis. CONCLUSIONS: Changes in blood flow velocity waveforms as measured by pulsed Doppler in the umbilical and fetal cerebral arteries can be induced by fetal blood sampling. Decreased resistance in the placenta and fetal circulation would imply release of nitric oxide.

[Biological diagnosis of malaria: dangers of the automated blood differential count]. / Diagnostic biologique du paludisme: dangers de l'automatisation de la formule sanguine.

Automated differential counting systems deprive laboratories of blood smear study and so malaria risks not to be diagnosed if plasmodium search is not prescribed by the physician. Some abnormalities (atypical lymphocytes called LUC and thrombopenia) can induce a blood smear. But a study of 96 patients shows that, during the first analysis, these abnormalities can miss for nearly a third of one's case. So it is very important to prescribe malaria search on blood smears when there is the least clinical symptom.

[Importance of a micro-computer in determining blood groups and in research on irregular agglutinins. Report of a new system]. / Intérêt d'un micro-ordinateur lors de la détermination des groupes sanguins et de la recherche d'agglutinines irrégulières. Présentation d'un nouveau système.

Use of data processing for blood groups in a general laboratory knocks against two challenges: entering of results in the computer that must not be a rewrite, source of errors; a quick entry into files often very old. We think that these problems are resolved by the system we describe.

[The severity of airport malaria]. / Gravité du paludisme des aéroports.

Report of a new case of airport malaria with renal failure. The evolution of the thirty cases previously described is reviewed. Most of the time, airport malaria seems to be a severe infection.

[Pitfalls in inquiries relating to malaria]. / Les pièges de l'interrogatoire en matière de paludisme.

In two cases of Plasmodium falciparum which could suggest a time interval of three and four years between departure from endemic area and onset of malaria symptoms, the authors insist on the fact that epidemiologic study must be very rigorous.

[Hereditary deficiency of factor XI in a Portuguese family, the propositus of which had Behçet's disease (author's transl)]. / Déficit constitutionnel en facteur XI: description chez une famille Portugaise dont le propositus a une maladie de Behçet.

The finding of a hereditary deficiency of factor XI in a Portuguese family confirms that this abnormality is not confined to Ashkenazi Jews. Its transmission is autosomal, recessive and of variable expression, and in this particular family it appeared to be asymptomatic. When infused post-operatively in fresh frozen plasma, Factor XI has a half-life of about 24 hours and a recovery rate of almost 100%. The propositus, a 57-year-old woman, appears to have been "protected" by a homozygous deficiency of Factor XI against the thromboembolic complications of a Behçets disease which had been present for 30 years. Plasma exchange and perfusions of fresh frozen plasma were probably responsible for the regression observed in the symptoms (particularly ocular symptoms) of the disease, then in active phase.