A self-assessed questionnaire can help in the diagnosis of pelvic inflammatory disease.

Background: Pelvic inflammatory disease (PID) is often responsible for acute pelvic pain, yet its clinical diagnosis is difficult. The aim of this study was to develop and validate prediction rules for the diagnosis of PID in patients seen for acute pelvic pain, based solely on a self-assessed questionnaire.

Methods: From September 2006 to April 2008, 499 consecutive patients presenting at the gynecology emergency departments of 5 hospitals for acute pelvic pain completed a Self-Assessment Questionnaire for Gynecological Emergencies.

[Diagnosis of pelvic inflammatory disease. Which clinical and paraclinical criteria? Role of imaging and laparoscopy?].

Diagnosis of pelvic inflammatory disease is difficult. We focus on a systematic literature review to study diagnostic values of history-taking, clinical examination, laboratory tests and imagery. After this literature review, we build a diagnostic model for pelvic inflammatory disease.

A life-threatening ectopic pregnancy with etonogestrel implant.

Background: Etonogestrel contraceptive implant is a highly effective subdermal method of long-acting hormonal contraception for women.

Case: We describe a case of ruptured ectopic pregnancy occurring in a patient with an etonogestrel contraceptive implant (Implanon®). The only factor predisposing to a failure in this case is a moderately elevated body mass index of 29.

Microsatellite instability analysis in uterine cavity washings as a screening tool for endometrial cancer in Lynch syndrome.

Although patients with Lynch syndrome (LS) are at high risk of endometrial cancer, gynecologic screening has been poorly investigated and diagnostic value of current screening tests remains unclear. Microsatellite instability (MSI) phenotype is found in more than 90% of endometrial cancers developed in LS patients. Here we report the first two cases of unstable endometrial tumors with detection of MSI in uterine cavity washings cells.

[Is there an interest in para-aortic lymphadenectomy in operable endometrial cancer?].

The indication and extent of lymph node dissection in the surgical management of endometrial cancer remains controversial especially concerning the para-aortic lymph nodes. The therapeutic benefit of the lymph node dissection is criticized mainly for low-risk patients for extra-uterine spread. Surgically staging patients is the best method to predict node involvement and it allows an optimal decision for adjuvant therapy to be taken.

[Sentinel lymph node biopsy under local anaesthesia: how to avoid the disadvantages of intraoperative examination?].

The sentinel lymph node procedure has become the standard in the surgical management of localised breast cancer. However, it is submitted to the uncertainties of intraoperative examination. Indeed, intraoperative examination has three major disadvantages: the type of histological method (frozen section versus imprint cytology), the size of sentinel node metastasis (macro- versus micrometastases) and the time requested for this technique.

[Klinefelter syndrome in 1993. Results of a multicenter study on 58 cases and review of the literature].

A retrospective multicenter study found 58 cases of Klinefelter syndrome of which 23 (39%) were diagnosed before puberty. Although as common as Down syndrome, Klinefelter syndrome is underdiagnosed and often recognized only in adulthood. Suggestive manifestations in infants, children, and teenagers include facial dysmorphism, micropenis, and delayed speech and should lead to examination of the karyotype.

[An unusual germ causing a limp: Eikenella corrodens].

A case of retroperitoneal appendicular abscess due to Eikenella corrodens is reported. This facultative anaerobe is normally found on the respiratory and intestinal mucosa and may be responsible for opportunistic infections. Culture is difficult and growth is slow.

[Neonatal pneumococcal septicemia].

We report two cases of neonatal pneumococcal septicemia, including one fatal case in a 32-week-gestational-age premature infant. Neonatal pneumococcal septicemias account for less than 1% of all neonatal infections. Diagnosis is provided by simple and rapid methods for identifying pneumococci.

[Metabolic and cardiovascular effects of beta-blockers taken by the mother in newborn infants].

The effects of beta-blockers administered to mothers with arterial hypertension were investigated in 38 neonates of varying gestational age and weight. During the first 48 hours of extra-uterine life, heart rate was continuously monitored and blood pressure and glycaemia were measured every 3 hours. Left ventricular function was studied by echocardiography on the first day post-partum, once again between the 5th and 10th days.

[Value of continuous Doppler velocimetry for the diagnosis of patent ductus arteriosus].

A study of the curve of wave Doppler ultrasonography of 3 arterial axes (carotid, subclavian and femoral) was performed in 32 children in whom the diagnosis of patent ductus arteriosus was suspected. A continuous 8 MHz wave directional ultrasonic Doppler apparatus was used. At the level of subclavian and femoral arteries, patent ductus arteriosus is associated with a negative holodiastolic wave on the curve.

[Evaluation of the search for soluble antigens in the cerebrospinal fluid from 31 cases of purulent meningitis in children].

Soluble antigens were looked for in 31 cases of purulent meningitis in children aged one day to 16 years. The latex technique was used in this study. Negative cases were controlled by counter-immune electrophoresis and by ELISA.

[Vein graft for thrombophlebitis of the lateral sinus following mastoiditis in a 14-year-old boy (author's transl)].

A boy 14 years is described who had partial agenesis of the right lateral sinus. Following thrombophlebitis of the left lateral sinus secondary to mastoiditis he developed progressive visual impairment due to papilledema. This was cured by vein graft between the right lateral sinus and the right external jugular vein.