Comparison of body composition, basal metabolic rate and metabolic outcomes of adults with Prader Willi syndrome or lesional hypothalamic disease, with primary obesity.

CONTEXT: The care of patients with hypothalamic obesity is challenging. OBJECTIVE: To compare body composition, basal metabolic rate (BMR) and metabolic outcomes of adults, with lesional or genetic hypothalamic obesity, with obese patients suffering from primary obesity, once matched for body mass index (BMI). DESIGN AND PATIENTS: Adults with hypothalamic obesity of genetic origin (Prader Willi syndrome (PWS)) or acquired hypothalamic damage (HD), such as craniopharygioma, were compared with obese control candidates awaiting bariatric surgery (C), with a BMI between 35 and 65 kg m(-)(2), and aged between 18 and 50 years. MAIN OUTCOME MEASURES: Body composition measured by whole-body dual-energy X-ray absorptiometry scanning, BMR using indirect calorimetry, hormonal and metabolic assessments. RESULTS: A total of 27 adults with a genetic diagnosis of PWS, 15 obese subjects with HD and 206 obese controls with similar BMI were studied. Compared with the control group, PWS patients had an increased percentage of fat mass (FM), and a decreased percentage of android FM. The BMR of PWS patients was significantly lower than controls and highly correlated with lean body mass in PWS and C patients. Body composition of HD was similar with those of obese patients. A trend toward an increased prevalence of diabetes in HD patients and of cytolysis in PWS was observed in comparison with primary obese patients. CONCLUSION: Genetic and lesional hypothalamic obesities have different consequences for phenotypic features such as body composition or BMR compared with primary obese patients. The mechanisms of adipose tissue development and metabolic complications may be different between genetic and lesional obesities.

[Contraception for transgender men: A case report and review]. / La contraception d'un homme transgenre : à propos d'un cas et revue de la littérature.

All methods of contraception used by a cisgender woman can theoretically be used by a transgender man. In practice, some contraceptives can aggravate gender dysphoria and should be discarded. On the other hand, contraceptives which make it possible to consolidate amenorrhea or to accentuate the virilization induced by taking testosterone will be better tolerated.

Synergistic effects of Lacticaseibacillus rhamnosus GG, glutamine, and curcumin on chronic unpredictable mild stress-induced depression in a mouse model.

The microbiota-gut-brain axis is important in anxiety-depressive disorders. These conditions are associated with dysbiosis of the intestinal microbiota, intestinal hyperpermeability and an increase in circulating markers of inflammation and oxidative stress. They are also associated with a deregulation of the glutamine-glutamate-γ-aminobutyric acid cycle, with impairment of the excitatory/inhibitory balance in the brain. Our aim was to examine the impact of chronic treatment with the probiotic organism Lacticaseibacillus rhamnosus GG, alone or in combination with glutamine and curcumin, in a validated model of anxiety-depressive disorder in mice. Six-month-old mice (n=144) were exposed to chronic unpredictable mild stress (CUMS) stimulation for 3 weeks and emotional disturbances were assessed using two tests assessing anxiety (elevated plus maze test) and depressive-like behaviour (tail suspension test). After discontinuation of CUMS, mice were force-fed once-daily with curcumin, glutamine and probiotic alone or in combination for 21 consecutive days. Emotional reactivity was assessed in two separate behavioural tests: open field test and forced swim test. The outcomes of the interventions were compared with those induced by acute intraperitoneal administration of clomipramine, one of the major tricyclic antidepressants used in humans. Two independent sets of experiment were performed in this study, in order to evaluate the effects of two different formulations based on the utilisation of the probiotic L. rhamnosus GG in its live or inactivated form. CUMS led to an impairment of the emotional state of 6-month-old mice. However, chronic treatment with a combination of glutamine, curcumin and L. rhamnosus GG rescued the anxiety and depressive-like phenotype with an efficiency similar to clomipramine. A synergistic effect of the three compounds was observed, suggesting that simultaneous action on different targets is a relevant approach for the management of anxiety-depressive disorders.

Disagreement between capillary blood glucose and flash glucose monitoring sensor can lead to inadequate treatment adjustments during pregnancy.

OBJECTIVE: Continuous glucose monitoring tends to replace capillary blood glucose (CBG) self-monitoring. Our aim was to determine the agreement between CBG and a flash glucose monitoring system (Flash-GMS) in treatment decision-making during pregnancy. RESEARCH DESIGN AND METHODS: Insulin-treated women with either type 1 (n=25), type 2 (n=4) or gestational diabetes (n=4) were included. A Flash-GMS sensor was applied for 14 days. Women scanned the sensor whenever they monitored their CBG. The primary endpoint was the proportion of discordant therapeutic decisions they would have made based on Flash-GMS rather than CBG results. Glucose averages, mean absolute difference (MAD), mean absolute relative difference (MARD) and Flash-GMS accuracy were also estimated. RESULTS: Data for forty 14-day periods were available. Preprandial Flash-GMS and CBG values were 93±42mg/dL and 105±45mg/dL, respectively (P<10-4), and 2-h postprandial (PP) values were 106±45mg/dL and 119±47mg/dL, respectively (P<10-4). MAD was 14±22mg/dL preprandial and 15±24mg/dL 2-h PP; MARD was 19%; and 99% of glucose value pairs were within the clinically acceptable A and B zones of the Parkes error grid. Concordance rate for therapeutic decision-making was 80-85% according to ADA targets and 65-75% according to a pragmatic threshold. At different time points of the day, 83-92% of discordant results were due to Flash-GMS values being lower than their corresponding CBG values. CONCLUSION: Flash-GMS tends to give lower estimates than CBG. Thus, in cases requiring therapeutic changes to treat or prevent hypo- or hyperglycaemia, 25-35% of choices would have been divergent if based on Flash-GMS rather than CBG.

[Viral failure in infants perinatally infected with HIV: A double punishment]. / Échec virologique chez les nourrissons infectés par le VIH par transmission périnatale : une double peine.

BACKGROUND: Considering the remarkable efficacy of the strategies for preventing mother-to-child transmission of HIV infection (PMTCT), failures are rare in high-resource countries and deserve further investigation. Moreover, infants have been found to be at increased risk of viral failure. We analyzed the factors related to the children's environment, including maternal psychological factors that may be associated with viral failure in children diagnosed before the age of 1 year. PATIENTS AND METHODS: Retrospective study of all HIV-infected infants, born in France between July 2003 and July 2013, diagnosed before the age of 1 year, cared for in a single reference center, comparing the group of children in viral success to the group of children presenting at least one episode of viral failure, using data available in their medical, psychological and social files. RESULTS: Out of 1061 infants included in the prospective PMTCT follow-up, eight infants were found HIV-positive and an additional six cases were referred from other centers before the age of 1 year, for a total of 14 children born to 13 mothers. Seven children presented durable optimal viral control (VL<50 c/mL) whereas seven others did not reach or maintain optimal viral control over time. The main difference between the two groups was the presence among the mothers of children with viral failure of severe psychological disorders, leading to treatment adherence problems in the mothers who were aware of their HIV status before pregnancy, and difficulties in giving their children's treatments correctly. CONCLUSIONS: Although seroconversion during pregnancy is responsible for a significant proportion of residual transmission in high-resource countries, severe psychological or psychiatric conditions in HIV-positive mothers play an important role on the risk of both MTC residual transmission and viral failure in their infants.

[Mode of delivery of HIV-infected women: a retrospective study of 358 pregnancies followed in the same hospital between 2000 and 2004]. / Accouchement des patientes enceintes infectées par le VIH: étude rétrospective de 358 grossesses suivies entre 2000 et 2004.

OBJECTIVE: Evaluate the mode of delivery of HIV-infected women and the risk of mother-to-child transmission. PATIENTS AND METHODS: A retrospective study conducted on HIV-infected women who delivered at the maternity ward of Bichat Hospital in Paris between 1st January 2000 and 31(st) December 2004. Pregnancy care, antiretroviral therapy, decision of the mode of delivery and neonate treatment were conformable to the French recommendations. RESULTS: The analysis was performed on 332 cases out of 358 pregnancies followed during this period. 75% received a Highly Active Anti Retroviral Therapy (HAART), 24% an AZT monotherapy and 1% did not receive any antiretroviral treatment. Plasmatic HIV viral load was under the level of detectability (50 copies/ml) for 64,6% of women under HAART and 28,7% of women under AZT monotherapy. Only 31,7% of women under HAART delivered vaginally. 44,7% of women under HAART with undetectable viral load at the moment of delivery delivered vaginally. 59,5% of women who were allowed to deliver vaginally had finally a vaginal delivery. 332 women gave birth to 341 babies with 9 twin pregnancies and one still-birth at 22 WA. Out of these 340 babies, 3 babies whose mother received HAART were HIV infected (2 in utero and 1 per-partum). DISCUSSION AND CONCLUSION: The reasons why only one third of HIV-infected women could deliver vaginally in this study are primarily the persistence of a detectable HIV viral load under HAART. Women's choice of the mode of delivery comes next, which depends on the quality of the counselling about the benefits and risks of the cesarean section in the context of HIV infection. The third reason is obstetrical contra indications to vaginal delivery in the context of HIV infection. In the future, it is possible to reduce the incidence of cesarean section in HIV-infected women by elevating the level of HIV plasmatic viral load which allowed vaginal delivery (1000 copies/ml), by improving the observance to antiretroviral treatment, by adaptating antiretroviral medications posology using determination of serum protease inhibitors concentration and by modifying obstetrical management with less restrictive contra indications to vaginal delivery. However the impact of prophylactic cesarean section when plasmatic HIV viral load is undetectable must still be evaluated.

[Complications of termination of pregnancy]. / Complications de l'interruption volontaire de grossesse.

The legalization of abortion in France allowed to disappear almost maternal deaths caused by induced abortions. Nevertheless, the practice of abortion in a medical framework is encumbered with a number of immediate complications. Similarly, the late consequences of the practice of surgical abortion have generated an abundant literature, which it is important to analyse, both to meet the legitimate concerns of patients as to prevent any spread of false ideas under the influence of movements opposed to abortion.

[Induced abortion: Guidelines for clinical practice - Text of the Guidelines (short text)]. / L'interruption volontaire de grossesse : recommandations pour la pratique clinique ­ Texte des recommandations (texte court).

OBJECTIVE: Develop recommendations for the practice of induced abortion. MATERIALS AND METHODS: The Pubmed database, the Cochrane Library and the recommendations from the French and foreign Gyn-Obs societies or colleges have been consulted. RESULTS: The number of induced abortions (IA) has been stable for several decades. There are a lot of factors explaining the choice of abortion when there is an unplanned pregnancy (UPP). Early initiation and choice of contraception in connection to the woman's life are associated with lower NSP. Reversible contraceptives of long duration of action should be positioned fist in line for the teenager because of its efficiency (grade C). Ultrasound before induced abortion must be encouraged but should not be obligatory before performing IA (Professional consensus). As soon as the sonographic apparition of the embryo, the estimated date of pregnancy is done by measuring the crown-rump length (CRL) or by measuring the biparietal diameter (BIP) from 11 weeks on (grade B). Reliability of these parameters being±5 days, IA could be done if measurements are respectively less than 90mm for CRL and less than 30mm for BIP (Professional consensus). A medical IA performed with a dose of 200mg mifepristone combined with misoprostol is effective at any gestational age (EL1). Before 7 weeks, mifepristone followed between 24 and 48hours by taking misoprostol orally, buccally sublingually or eventually vaginally at a dose of 400 ug possibly renewed after 3hours (EL1, grade A). Beyond 7 weeks, misoprostol given vaginally, sublingually or buccally are better tolerated with fewer side effects than oral route (EL1). It is recommended to always use a cervical preparation during an instrumental abortion (Professional consensus). Misoprostol is a first-line agent for cervical preparation at a dose of 400 mcg (grade A). Aspiration evacuation is preferable to curettage (grade B). A perforated uterus during an instrumental suction should not be considered as a scarred uterus (Professional consensus). IA is not associated with increased subsequent risk of infertility or ectopic pregnancy (EL2). The pre-abortion medical consultations does not affect, most of the time, the decision to request an IA. Indeed, a majority of women is quite sure of her choice during these consultations. Acceptability of the method of IA and satisfaction appears to be larger when they are able to choose the abortion method (grade B). There is no relationship between an increase in psychiatric disorders and IA (EL2). Women with psychiatric histories are at increased risk of mental disorders after the occurrence of an UPP (EL2). In case of instrumental abortion, oral estrogen-progestogen contraceptives and the patch should be started from the day of the abortion, the vaginal ring inserted within 5 days of IA (grade B). In case of medical abortion, the vaginal ring should be inserted within a week of taking mifepristone, oral estrogen-progestogen contraceptives and the patch should be initiated on the same day or the day after taking prostaglandins (grade C). In case of instrumental abortion, the contraceptive implant may be inserted on the day of the abortion (grade B). In case of medical abortion, the implant can be inserted on the day of mifepristone (grade C). The copper Intrauterine Device (IUD) and levonorgestrel should be inserted preferably on the day of instrumental abortion (grade A). In case of medical abortion, an IUD can be inserted within 10 days following mifepristone after ensuring by ultrasound of the absence of intrauterine pregnancy (grade C). CONCLUSION: The implementation of these guidelines may promote a better and more homogenous care for women requesting IA in our country.

[The efficacy and acceptability of mifepristone medical abortion with home administration misoprostol provided by private providers linked with the hospital: a prospective study of 433 patients]. / Efficacité et acceptabilité de l'interruption volontaire de grossesse par méthode médicamenteuse pratiquée sans hospitalisation dans le cadre d'un réseau ville-hôpital: étude prospective sur 433 patientes.

BACKGROUND: Until July 2001 medical abortion was only authorized in France in public hospitals or private clinics. A new law effective in July 2001 allows private practitioners (gynaecologists or general practitioners) to provide medical abortion in their offices as long as they are linked to a hospital official agreement. Unfortunately mifepristone was not available outside hospitals before September 2004, so the study was conducted still providing the drugs in the hospital family planning clinic. OBJECTIVE: To evaluate the efficacy and the acceptability of mifepristone medical abortion with home administration of misoprostol provided by private practitioners linked with the hospital. PATIENTS AND METHODS: Four hundred thirty-three women seeking medical abortion before 7 weeks LMP were included between 2 January 2003 and 7 July 2004. All consultations before abortion and 2 weeks after abortion took place in a private provider's office. Drugs were administrated in the hospital family planning clinic: patients were given 3 tablets of mifepristone (600 mg) orally by the midwife and received 2 tablets of misoprostol (400 microg) that they would take at home 48 hours later. In case of any problems or complications, patients could phone or meet their private providers, phone the hospital midwife or go to the hospital emergency service. Private providers received training in medical abortion training and could at any time reach a medical specialist in the hospital family planning clinic for information or to refer a patient. RESULTS: - Efficacy was evaluated for 339 women, because 94 patients were lost to follow-up (21.7%). Efficacy of medical abortion was 93.8% (318/339). There were 21 surgical aspirations (6.2%): for women's decision in 1.5% of cases, for medical decision without complications in 3.5% of cases, and for failure of the method in 1.2% of cases (2 ongoing pregnancies and 2 heavy haemorrhages with transfusion). The family planning midwife received a phone call from 21 patients after mifepristone (4.8%), Twenty-five patients had an emergency consultation (5.7%), and 22 patients went back to their private providers before their appointment for follow-up (5%). Twenty-two patients (5%) were referred by the private provider to the hospital medical specialist. Acceptability is known for 26% of patients; 96.2% thought that the abortion procedure was acceptable. DISCUSSION AND CONCLUSIONS: The failure rate of medical abortion in this study is largely due to aspirations for incomplete abortion. To improve the efficacy of medical abortion offered by private providers linked with the hospital, all the relevant professionals (private providers, residents in the emergency service, family planning providers) must be well trained in medical abortion, especially in how to interpret and react to ultrasound images obtained in the follow up visit. The procedure is very acceptable to women. Medical abortion offered via a network should be well accepted by practitioners, since only 5% of women will need more than two consultations and only 6.2% will need surgical aspiration in the hospital. This study allows us to be optimistic about the expansion of medical abortion in France outside the hospital via a provider-hospital network based on the fact that since September 2004 private providers can get mifepristone directly in the pharmacies of the city.

[Impact of media alerts on contraceptive pills medication]. / Enquête concernant le retentissement des alertes médiatiques sur la pilule.

INTRODUCTION: The end of 2012 was marked by some media alerts regarding combined hormonal contraceptives (CHC) and lawsuit against pharmaceutical companies selling these birth control pills. In this study, we analyzed whether these information had an impact on the number of abortion. METHODS: Prospective study determining the number of women asking for abortion and who spontaneously declare that the contraception defect was due to an abandon of their oral contraception as they were scared of some information they received from media about the medication. RESULTS: Eleven centers out of 16 did participate to the study, allowing the study of 2300 abortion during this time frame. Ninety-eight of these pregnancies (4.2%) were due to an interruption of the contraceptive treatment as a consequence of media alerts. Average age was 26 years old. Within these pregnancies, 4 (6%) started in December 2012, 3 months after the beginning of the alerts, 11 (16%) in January, 24 (36%) in February and 18 (27%) in March 2013 (4-6 months later). In 7 cases (10%) CHC stopped by fear of information reported by media were of 2nd generation, in 17 cases (25%) of 3rd generation, in 32 cases (48%) of 4th generation and microprogestative in 2 cases (3%). CONCLUSION: Women who declared that they stopped their birth control medication by fear of information reported in media, represented 4% of the number of abortions performed between 2013 February 18th and 2013 April 30th.

Intraerythrocyte and plasma osmolality during graded exercise in humans.

The purpose of this study was to measure intraerythrocyte and plasma osmolality during graded exercise in humans. Eight volunteers performed a maximal exercise test on a cycle ergometer. Mean corpuscular volume, mean corpuscular hemoglobin concentration, and erythrocyte water content were not significantly (P less than 0.05) affected by the exercise bout in spite of a significant mean increase of 6.7% in plasma osmolality. Interestingly, intraerythrocyte osmolality also increased significantly during the exercise bout, paralleling the response seen in the plasma. In fact, plasma osmolality and intraerythrocyte osmolality demonstrated a significant linear relationship (r = 0.91). These data suggest that during exercise the human erythrocyte has the ability to increase its osmolality in vivo to match that of the plasma. Therefore, this mechanism allows for erythrocyte volume to remain relatively unchanged during exercise despite a significant increase in plasma osmolality.

2.5 years follow-up of weight and Body Mass Index values in the Weight Control for Life! program: a descriptive analysis.

This descriptive study monitored weight, Body Mass Index, and percent excess weight changes in 60 clients, (44 women, 16 men) at about 1 year and 2.5 years following participation in the Weight Control for Life! program. The program integrates the habit reversal treatment model with contingency management and operant reinforcement principles; nutrition education; physical activity; stress management; cognitive-restructuring; relapse prevention; social support; intensive, on-going maintenance; self-monitoring; and the use of a medically supervised very-low-calorie diet or low-calorie-diet. Clients' pretreatment and posttreatment weights averaged 104.28 kg (229.42 lb) and 79.89 kg (175.76 lb), respectively, representing a 68% reduction in excess body weight at the end of the weight loss phase of the program. Mean weight loss at about 1 year and 2.5 years post weight loss was 19.28 kg (42.42 lb) and 13.09 kg (28.80 lb), indicating subjects maintained 75% and 52% of their weight losses at these two time periods. Men lost more weight and maintained better losses than women. Overall, there was a 41% reduction in excess body weight at the end of 2.5 years.

Lifetime history of relapse from exercise.

Most research on relapse from exercise has investigated one relapse episode following a structured program. The present study examined the patterns and determinants of the lifetime history of relapse from exercise in a community population. Subjects were 1.811 randomly selected residents of San Diego, California who completed an extensive mailed survey. Subjects reported the number of times over their lifetime that they had exercised vigorously for at least six months and then stopped exercising for at least three months. Approximately 60% of subjects reported zero relapses, 20% reported one or two relapses, and 20% reported three or more relapses. Relapse histories of current exercisers and current nonexercisers were virtually identical. The most commonly reported reason for the last relapse was injuries for both nonexecisers and exercisers. Multiple regression analyses were used to identify correlates of exercise relapse history. These data indicate that cross-sectional surveys of exercise behavior are inadequate to characterize exercise behavior in a population, and injuries are probably a major cause of relapse.

[Clinical and ultrastructural study of a case of human rabies]. / Etude clinique et ultrastructurale d'un cas de rage humaine.

A patient of Morracan origin, aged 26 years, who died as a result of rabies after a 15 day illness in August 1976 in Bordeaux. No evidence of contamination was found by history from the patient and his family and friends nor by examination. A cerebral biopsy carried out a few hours before death confirmed the diagnosis by immunofluorescence, whilst examination under the optical microscope demonstrated Negri bodies and ultrastructural studies revealed rabies virus. These findings are discussed and compared with a few other cases reported in the literature with electron microscope studies.

[Maternity in adolescence: obstetrical analysis and review of the influence of cultural, socioeconomic and psychological factors in a retrospective study of 62 cases]. / Maternité à l'adolescence: analyse obstétricale et revue de l'influence des facteurs culturels, socio-économiques et psychologiques à partir d'une étude rétrospective de 62 dossiers.

OBJECTIVE: To analyse obstetrical outcome of teenage pregnancies and conditions of discharge from the maternity ward. PATIENTS AND METHODS: A retrospective study of 62 deliveries of women 13 to 17 years old, between 1997 and 2000. RESULTS: A majority of patients is aged 16 or 17 (92%); 46.8% of teenagers were born in a sub-Saharan African country. The teenagers do not go to school in 45.2% of the cases. The first visit to hospital is late in the pregnancy (40.3% had their first visit after 30 weeks of amenorrhoea). There was no follow-up at all for 17.7% of the pregnancies. The obstetrical outcome is normal in 66.2% of the cases; 93.5% of the children were born after 37 SA and had a normal weight for gestational age; 93.5% were discharged from the maternity ward with their children. A specific follow-up took place for 36.2% of the women. Compared with women from other origins, teenagers born in sub-Saharan Africa more often live with their boyfriend (P = 0.03), who is likely to be over 25 (P = 0.001). Sub-Saharan African women more often return and live at the father's home (P < 0.001) and a specific follow-up proves less often necessary (P = 0.03). DISCUSSION AND CONCLUSION: In developed countries, obstetrical outcome of teenage pregnancies is generally good if the women are more than 15 years old. In some cases, teenagers want to have a child for socio-economical, cultural or psychological reasons. There is a great variability of interpersonal situations as shown in this study, where a better prognosis was found in sub-Saharan African teenagers. It is recommended to permit an early access to the maternity hospital and to provide economical and psychological support during and after pregnancy.

[Management of pregnant women infected with HIV at Bichat Hospital between 1990 and 1998: analysis of 202 pregnancies]. / Prise en charge des femmes enceintes infectées par le VIH à l'hôpital Bichat entre 1990 et 1998: analyse de 202 grossesses.

OBJECTIVE: To describe medical and obstetrical prenatal care of pregnant women infected by HIV-1 emphasizing the role of cesarean section. DESIGN: A retrospective study of 202 pregnancies followed between 1990 and 1998 in a french hospital in Paris. RESULTS: 56.9% of the women were born in subsaharian Africa; 80.2% were infected by sexual intercourse and the seropositivity was discovered during the pregnancy in 51% of the cases. Viral coinfections by hepatitis B virus, hepatitis C virus and Human papillomavirus were found respectively in 14.7%, 16.5% and 13% of the pregnancies. Prematurity occurred in 15% of the deliveries. Efficacy of antiretroviral therapy was confirmed in this study: 5.7% of the children were infected despite the antiretrovial treatment versus 19.3% without treatment (p < 0.03). Prophylactic cesarean section was proposed to the patients since 1994; the morbidity of cesarean was 8.8% (69 cesarean sections). CONCLUSION: The policy of the association of prophylactic cesarean section and monotherapy by Zidovudine is validated by recent studies. The extension of prophylatic cesarean section to all the pregnant women infected by HIV is proposed. However the evaluation of the morbidity of the cesarean section in HIV infected women needs a prospective case-control study.

[Mother-to-child transmission of hepatitis C virus: recent news about the benefit of caesarean sections]. / La transmission materno-foetale du virus de l'hépatite C : actualités sur l'intérêt de la césarienne.

The rate of mother-to-infant transmission for hepatitis C virus is estimated to be around 5% of viraemic mothers and represents an important route of HCV infection among children. Transmission is possible in utero but the highest risk of infection is at or near the time of delivery because of an important blood transmission of hepatitis C virus. Mothers with high levels of HCV-RNA and co-infected for human immunodeficiency virus are documented to have risk factors for vertical transmission of HCV. Thus, for these, the mode of delivery must be discussed even if there are no precise recommendations. Among obstetrical risk factors, the results of literature fail to prove a benefit of elective caesarean delivery in the aim to reduce the vertical transmission of HCV. However, obstetrical situations with a high risk of blood contact between mother and foetus must be considered and if possible evicted.

[Hepatic distomatosis caused by Clonorchis/Opisthorchis spp. in refugees from South-East Asia. Effects of treatment with praziquantel]. / Etude des distomatoses hépatiques à Clonorchis/Opistorchis spp. chez des réfugiés d'Asie du Sud-Est. Effets du traitement par le praziquantel.

The prevalence of liver infection (percentage of patients voiding Clonorchis or Opistorchis spp. eggs in faeces) is 18.5% in the South East Asian refugees. Both sexes are equally affected and the older the refugees are, the more often they are found infected. Laotians, who like to eat the fishes raw, are harboring leverflukes more often than other Far-east inhabitants. Praziquantel, prescribed at a dose of 25 mg/kg body weight given 3 times on a single day, is very efficient in the treatment of the Far-east hepatic distomatosis. Tolerability to praziquantel is excellent. Side effects are few and of moderate intensity.