Fetal intracerebral hemorrhage and cataract: think COL4A1.

The COL4A1 gene encodes the alpha1 chain of type IV collagen, a crucial component of nearly all basement membranes. Mutations in COL4A1 were first associated with cerebral microangiopathy and familial porencephaly. Recently, several authors have reported mutations in COL4A1 as a Mendelian cause of prenatal onset intracranial hemorrhage (ICH). We report two cases of prenatal ICH associated with cataract and suggest that COL4A1 mutation should be envisaged in fetuses with prenatal ICH, especially in the presence of lens abnormalities at ultrasound examination.

[The internal breast flap: a new technique of reconstruction]. / Le lambeau mammaire interne: une nouvelle technique de reconstruction.

AIM: The internal breast pedicle flap is not a well-known technique yet. Anyway, it is effective for some of breast reconstructions and partial thoracic defects. This technique is applied to patients presenting breast hypertrophy. In this article, we present the experience of our department in this technique, considering its indications, surgery details, complications that may occur and subsisting interrogations about this surgical approach. MATERIAL AND METHODS: Two patients were treated with internal breast pedicle flap, one for controlateral breast reconstruction and one for coverage of partial thoracic defect. RESULTS: Patients were followed; flap survival and aesthetic results were analyzed during consultations. Results were good and similar to other well-spread reconstruction techniques. CONCLUSION: The internal breast pedicle flap is a relevant, reproducible and easy technique. Overall results are satisfying and allow the possibility of applying other techniques in case of failure. You have to keep in mind the risk of making a transfer of a potentially carcinogenic tissue for a patient having already presented a breast cancer.

[Impact of hospital infection on medical expenditures in a continuing care and rehabilitation service at a geriatric hospital]. / Impact de l'infection nosocomiale sur les consommations médicales en service de soins de suite et réadaptation dans un hôpital gériatrique.

The costs of medical expenditures such as drugs, medical devices (MD), biological assays and nurses workload, were measured, before and after the onset of nosocomial infection (NI), in rehabilitation care departments of a 1000-beds geriatric teaching hospital. Data were collected retrospectively in medical records and nursing records. Nurse's workload was measured by the French indicator "Soins Infirmiers Personnalisé à la Personne Soignée" (SIIPS). A week before and a week after the diagnosis of hospital-acquired infection, medical consumptions were compared. During the study 38 of the 206 patients admitted in rehabilitation care wards presented hospital-acquired infection. Data were collected for 31 of these 38 patients. Nosocomial infections are associated with an increased pharmaceutical dispensing: medication (mainly antibiotics) and medical device's cost; and an increased nurse's workload. This study suggests that infection surveillance may be helpful to a better understanding of pharmaceutical dispensing variation in geriatric rehabilitation care departments.

Choroidal neovascularization complicating epiretinal membrane removal.

PURPOSE: Surgical removal of epiretinal membranes generally leads to anatomic and functional improvement. Main complications include cataract, retinal breaks and detachment. We describe the onset of a juxtafoveal choroidal neovascularization 2 years after surgery of an epiretinal membrane. METHODS: The neovascular membrane was treated by argon laser photocoagulation. RESULTS: Complete obliteration of the neovascularization was obtained resulting in functional improvement. CONCLUSIONS: Although rare, choroidal neovascularization as a complication of epiretinal membrane surgery must be suspected in case of poor visual outcome or relapse of symptoms.

Effects of bicuculline-induced seizures on benzodiazepine and adenosine receptors in developing rat brain.

The effects of seizures induced by an acute administration of bicuculline have been investigated on the central benzodiazepine and adenosine receptors in developing rats and in adults. Generalized seizures rapidly increased the total number of both benzodiazepine binding sites and adenosine A1 receptors, without changes in receptor affinity (KD). It was concluded that such a phenomenon may facilitate the anticonvulsant action of benzodiazepine and adenosine via receptor binding and that it could be an adaptative process to protect subjects against recurrent seizures, especially in newborns.