Do children and adolescents with type 1 diabetes suffer from a lack of resources in France? Results from a benchmark study in the New Aquitaine region.

Background: A benchmark study was conducted in the southwest of France, in the New Aquitaine region, to investigate metabolic outcomes and availability of resources in pediatric diabetes units. We assessed whether the level of care was in accordance with the International Society for Pediatric and Adolescent Diabetes recommendations.

Methods: Demographic and clinical data were collected, as were all HbA1c tests for the 2017 calendar year.

Long-term evolution of endocrine disorders and effect of GH therapy in 35 patients with pituitary stalk interruption syndrome.

We report long-term evolution of endocrine functions and the results of GH treatment in 35 patients (26 male and 9 female) with pituitary stalk interruption. At diagnosis, mean chronological age was 4.8 +/- 2.

[Laparoscopic treatment of abdominal incisional hernias].

Current management of incisional hernias is based on the tension free parietoplasty with prosthesis. This option is considered as the gold standard leading to a recurrence rate lower than 10%. Laparoscopic approach involves the placement of a composite intraperitoneal prosthesis obstructing the wall defect without anatomic reconstruction or peritoneal excision.

[Osteoarticular brucellosis and signs of autoimmunity].

Unlabelled: We report two cases of osteoarticular brucellosis in childhood, which illustrate the diagnostic difficulties in non-endemic areas.

Case Report: A 12-year-old boy was admitted for a unilateral sacroiliitis for which the brucellosis origin was established by serological and blood cultures (without fever). Autoimmunity was detected and disappeared following the treatment of the affection.

Classification and surgical treatment of incisional hernia. Results of an experts' meeting.

Background: The treatment of incisional hernia (IH) is a current problem in modern surgery. Many important aspects of incisional hernia surgery are yet to be answered, especially the choice of surgical technique and its adaptation to the individual patient. The aim of this experts' meeting was to resolve some current questions in incisional hernia surgery and to organise an international hernia register.

[Self-healing Hashimoto-Pritzker histiocytosis].

Unlabelled: Congenital 'self-healing' Langerhans' cell histiocytosis of Hashimoto-Pritzker is a rare disease occurring mainly in the neonatal period.

Case Report: We report on the case of a newborn with widespread eruption since birth, consisting of nodules, papulonodules, sometimes with ulcerations and scabs, concerning all the body, with a predilection for the cephalic area and the scalp, without general abnormalities. The clinical examination, histopathological data, immunohistochemistry, and the benign evolution in nine-, 18- and 24-month periods without particular treatment define the diagnosis of congenital self-healing Langerhans' cell histiocytosis of Hashimoto-Pritzker.

Replacement of a tracheal segment by a mixed graft (aorta and prosthesis): an experimental study in rabbits.

Objective: To develop a new graft and to verify its technical feasibility, viability, and ability to reduce the risk of infection by interposition of an aortic segment between the airway and the prosthetic component of the graft.

Design: Experimental study.

Setting: Multicentre study, France.

Buprenorphine withdrawal syndrome in a newborn.

A pregnant woman who was addicted to heroin rapidly withdrew from illicit drugs after the onset of a 4 mg/day buprenorphine treatment. In the newborn's blood, urine, and meconium 20 hours after birth, high concentrations of buprenorphine and its metabolite norbuprenorphine were detected, with a higher buprenorphine/norbuprenorphine ratio than in adults, possibly as a consequence of immature hepatic function; no illicit drugs were found. The child had a weak withdrawal syndrome on the second day of life and recovered rapidly.

Magnetic resonance angiographic analysis of atlanto-axial rotation: anatomic bases of compression of the vertebral arteries.

The aim of this study was to identify the functional anatomic factors involved in the maintenance or disturbance of flow in the vertebral aa. during atlanto-axial rotation. Fourteen healthy volunteers were studied by magnetic resonance angiography (MRA) by a three-dimensional sequence in phase contrast centered on the vertebral aa.

The abdominal linea alba: an anatomo-radiologic and biomechanical study.

Traditionally, the linea alba represents the principal route of approach in abdominal surgery and in consequence it is the commonest site of incisional hernia. The aim of this study was to review its morphology and to study its mechanical parameters of resistance, deformation and elasticity in order to compare these with the prosthetic materials most often used in the treatment of incisional hernia. Forty fresh cadavers were dissected and tests with a dynamometer and "bursting strength tester" were performed on samples taken from the linea alba at three levels: supra-umbilical, subumbilical and umbilical.

[Abdominal wall prostheses. Biomechanic and histological study].

The best prosthetic material is one which provides the best mechanical resistance with the best biological tolerance. In order to assess the mechanical and histological properties of abdominal wall prostheses, we performed experimental tests in animal models comparing four materials: polypropylene, dacron, polyglactine 910 and a dacron-polyglactine 910 composite. One hundred thirty rabbits were used including 10 controls and 120 test animals.

[Hyperexplexia].

Hyperexplexia is a disease of neonatal onset characterized by an exaggerated startle reflex. Early diagnosis is important to rule out epilepsy. Clinical findings are mainly hypertony and generalized startle reflex which is exaggerated by tiredness and some exogenous stimuli.

Possible involvement of a gamma-hydroxybutyric acid receptor in startle disease.

Startle disease or hyperreflexia is an autosomal dominant neurological disorder, with a neonatal onset, characterized by muscular hypertonia and myoclonic jerks, exaggerated by the slightest stimulus. Low concentrations of free gamma-aminobutyric acid (GABA) have been found in the cerebrospinal fluid of two affected infants. The involvement of GABA or its receptors has been raised and the use of GABA-agonist drugs has been suggested.

The venous drainage of the pancreas.

With the aim of clarifying certain contradictory aspects of the description of the venous drainage of the pancreas, a review of the literature and an anatomic study were carried out. Fifty duodeno-pancreatic blocks were studied by the injection-corrosion technique, of which 45 were available for study of the right pancreas and 37 for that of the left pancreas. The venous drainage of the duodeno-pancreas is effected via two territories: a posterosuperior and an anteroinferior, the former draining toward the portal v.

Three-dimensional CT analysis of atlantoaxial rotation: results in the normal subject.

A three-dimensional analysis of atlantoaxial rotation was made by computed tomography in ten healthy subjects. The method described allowed study of spatial relations between C1 and C2 interspace under both static and dynamic conditions, using a projection in a fixed transverse plane. The results demonstrated an axis of rotation for C2 slightly anterior to that for C1.

Anatomic basis of venous drainage in gastric tubular esophagoplasty.

This study was made with the aim of specifying the general architecture of the venous system of the stomach and its mode of drainage under normal conditions, and also of investigating the role of the venous drainage in the origin of disunion, anastomotic fistula and structure after tubular esophagoplasty pedicled on the right gastroepiploic vessels. Sixty stomachs removed from fresh cadavers were studied by injection-corrosion, using colored Altufix P10 as the injection mass. 35 specimens were injected globally via the superior mesenteric v.

[Extensive ulceronecrotizing anorectitis caused by abuse of analgesic suppositories].

Usually considered as totally unoffensive, antalgic suppositories can, under certain conditions, lead to extensive anorectal injury with anatomic, functional and legal implications which we evaluated on the basis of two cases and a review of the literature. Clinicians, surgeons, pathologists and pharmaceutical firms should be aware of these pathophysiological events. Consumer information is required to reduce the risk of self-medication.

Radioanatomic study of the gastrocolic venous trunk.

The mode of formation, measurements and frequency of occurrence of the gastrocolic venous trunk were studied by the injection-corrosion technique in a series of 54 anatomic specimens and by the analysis of 50 CT studies in patients without hepatic or pancreatic disease. The gastrocolic trunk was found in 51 of the 54 anatomic specimens and in 27 of the 50 CT studies. The great variability in its formation, whether bipodal, tripodal or quadripodal, was noted.

Anatomic basis of the physiopathology of the epicondylalgias: a study of the deep branch of the radial nerve.

Compression of the deep branch of the radial n. during its passage through Fröhse's arcade in the supinator m. is one of the classical explanations advanced for epicondylalgia.