Positive predictive value of seroconversion or positive rubella IgM in diagnosis of maternal rubella infection: Seven-years review of French National Reference Laboratory for Rubella.

BACKGROUND: In France, as in most developed countries, childbearing age women are routinely screened for rubella antibodies to identify and vaccinate susceptible women. Immunity to rubella is usually determined by measuring the rubella virus-specific immunoglobulin G (RV-IgG). In case of seroconversion for RV-IgG and/or positive RVIgM during pregnancy, laboratories usually send serum samples to the French National Reference Laboratory (FNRL) for Rubella in order to perform complementary investigations and confirm or exclude rubella infection during pregnancy. OBJECTIVE: Our aim is to report results of these investigations during a seven-year period (2013-2019) and evaluate the positive predictive value (PPV) of RV-IgG seroconversion or positive RV-IgM to diagnose maternal rubella infection in France. STUDY DESIGN: Between 2013 and 2019, 5398 serum samples collected from 4104 pregnant women, were addressed to FNRL because of RV-IgG seroconversion (N=899) or positive RV-IgM (N=3205). Additional serological tests were performed, mainly immunoblot (to look for the presence of anti-E1 protective antibody) and RV-IgG avidity (to exclude or confirm primary infection). RESULTS: Overall, for 3724/4104 (90.8 %) women, rubella primary-infection during pregnancy was formally excluded and maternal rubella primary-infection was only confirmed in 46/4104 (1.1 %) cases. CONCLUSION: Clinicians and biologists should be particularly aware that RV-IgG seroconversion or positive RV-IgM, in the current context of low RV circulation in France are most often not rubella primary infections. PPV of seroconversion to assess maternal rubella primary infection is as low as 0.2 % (95 % CI: 0 %; 0.5 %) and PPV of positive RV-IgM is only of 1.4 % (95 % CI: 0.99 %; 1.81 %).

[Dacryocystorhinostomy. Retrospective study of 165 cases. Indications. Technic. Results. Comparative study of 25 cases of injury with 165 cases including all etiologies]. / La dacryocystorhinostomie. Etude rétrospective de 165 cas. Indications. Technique. Résultats. Etude comparée de 25 cas traumatiques à 165 cas toutes étiologies confondues.

A retrospective study of 165 cases of dacryocystorhinostomy (DCR) has been performed in order to establish a relationship between the results and the delay between the initial symptoms and the DCR. The study compares the results obtained in 25 cases of DCR performed for post traumatic injury to those obtained in 165 cases of DCR performed for various etiologies (traumatic cases included). Traumatic cases are more frequent in men 19/ 25 cases (73%); infectious etiologies are more frequent in women 98/ 118 cases. The results are nearly the same for all the etiologies: 87% good results for the overall (147 cases), 88% good results for the traumatic cases (24 cases). The stenosis occurs within the first month in 72% and before the fourth month in all the cases. There is no difference in the results according to the surgical technique however the small number of each group does not allow a statistical analysis. The results are better when the delay between the initial traumatism or the first surgical repair and the DCR is more than six months (15 good results for 15 cases). The results were worse when the delay is less than 6 months (6 success for 9 cases), with p = 0.07 in the statistical analysis.

[Use of polytetrafluoroethylene (Goretex) in the palpebrofrontalis muscle suspension in ptosis]. / Utilisation du PFTE (Goretex) dans la suspension palpébro-frontale pour le ptosis.

The PFTE (Goretex) is a new material of expanded polytetrafluoroethylene with biocompatible properties and little foreign body reaction. It is useful in correction of ptosis by suspension of lid to frontalis muscle avoiding the sampling of autogenous fascia lata in the upper leg. Details of the surgical technique are discussed.

[Embryologic study of the lacrimal ducts in man. Apropos of 10 cases]. / Etude embryologique des voies lacrymales chez l'homme. A propos de dix cas.

The embryology of the human lacrimal system is not clearly defined in the literature and two hypotheses exist: the first suggests that the origin of the lacrimal system is from an ectodermal fold forming a sulcus of the naso-optic fissure. The second, with few defenders, describes the first rod of cells as meeting a second one which appears to emerge from the primitive nasal cavity. A study of ten human embryos, aged from 14 to 25 weeks and with a length of 12 to 33 cm, examined by histologic sections of 10 microns, revealed no lacrimal origin in the primitive nasal cavity near the inferior meatus. A further interesting point was that in three of the four embryos aged four months the lacrimal point was opened. Most authors, however, found the lacrimal sac and the nasolacrimal duct to be dilated, especially in one case where the inferior part of the nasolacrimal duct at the ostium below the inferior turbinate and meatus was widely dilated. In all the cases, the lower end of the duct was separated from the nasal cavity by a fine membrane in opposition with the nasal mucosa.