Quarterly individual outpatients lifestyle counseling after initial inpatients education on type 2 diabetes: the REDIA Prev-2 randomized controlled trial in Reunion Island.

Aims: This study aimed to describe the 1-year evolution of type 2 diabetes (T2D) patients who attended inpatients education, and to assess whether quarterly outpatients counseling visits by nurses and dietitians can improve metabolic control and health-related behaviours.

Methods: Following in-hospital educational sessions, 398 adult T2D patients were randomized to either attend quarterly individual lifestyle counseling visits by a nurse and a dietitian (intervention group), or receive the usual care (control group). Primary (HbA(1c)) and secondary endpoints (fasting blood glucose, lipids, body mass index, waist circumference, fat mass, blood pressure, diet, physical activity) were assessed at baseline and at 12 months.

[Postnatal investigation and outcome of isolated fetal renal pelvis dilatation].

Unlabelled: The purpose of this study was to evaluate the prognosis of fetal renal pelvis dilatation in relation to the degree of prenatal dilatation and the postnatal ultrasonography assessment. Based on these results, an algorithm is proposed for the choice of postnatal investigations and follow-up in children with fetal renal pelvis dilatation.

Material And Methods: The study was conducted prospectively among 10,677 newborns in Avignon over a nearly 5-year period.

Diabetic ketoacidosis revealing glucose-6-phosphate dehydrogenase deficiency: description of an adult case.

The discovery of an haemolytic anemia after a diabetic ketoacidosis led us to diagnose glucose-6-phosphate dehydrogenase (G6PD) deficiency in a 38-year old male patient. After a favorable course, we reviewed the links between this genetically transmitted enzymatic defect and diabetes mellitus, a public health concern in La Réunion. This description is a rare case of G6PD deficiency revealed after diabetic ketoacidosis in an adult.

Is the Kasai operation still indicated in children older than 3 months diagnosed with biliary atresia?

Objectives: The prognosis of hepatoportoenterostomy (the Kasai operation) for biliary atresia worsens when the age at surgery increases. This study examines whether the Kasai operation remains justified after 3 months of life.

Study Design: Records for all patients with biliary atresia living in France and born in the years 1986 to 1996 were reviewed, and patients were classified into 3 groups: group 1 (n = 30), no contraindication to the Kasai operation, but orientation to de novo transplantation; group 2 (n = 380), age at Kasai operation <90 days; and group 3 (n = 60), age at Kasai operation > or =90 days.

Epidemiology of biliary atresia in France: a national study 1986-96.

Background/aims: The reported incidence of biliary atresia varies from 5 to 32/100000 live births. The existence of seasonality and/or clustering is controversial. Based on a large population analysis, we examined the incidence of biliary atresia in France, and the space-time distribution of cases.

Prognosis of biliary atresia in the era of liver transplantation: French national study from 1986 to 1996.

Since the sequential treatment of Kasai operation with or without liver transplantation became available, the overall prognosis of biliary atresia remains unclear. This study examined the prognostic factors from diagnosis. All patients with biliary atresia living in France and born in the years 1986 to 1996 were reviewed.

Paediatric liver transplantation with a split graft: experience at Bicêtre.

Unlabelled: This study evaluates the results of paediatric liver transplantation (PLT) with split liver grafts at Bicêtre hospital.

Patients And Methods: Between January 1, 1988 and December 31, 1995, 205 PLT were performed in 180 children. One auxiliary PLT was excluded from the study.

[Neuro-intellectual prognosis at school age for 62 children born with a gestational age of under 32 weeks].

Aim: The aim of this study was to detail the incidence of cerebral palsy in children born before 32 weeks of gestation and to evaluate the scholastic and intellectual performance in non-handicapped children.

Population And Methods: The population included 63 survivors hospitalized in 1984-85 (gestational age: 30.06 +/- 1.

Haemophilia A: two cases showing unusual features at birth.

We report two patients with severe haemophilia A, factor VIII < 2 u dL-1, diagnosed at birth, through isolated bleeding in the adrenal gland (case 1) and through a haematoma in the liver (case 2). In these two clinical cases, the vital emergency, with haemorrhagic shock, required early diagnosis of the hereditary coagulation defect. Generally at birth, any unexplained bleeding should prompt screening for haemophilia.

[Agranulocytosis after application of silver sulfadiazine in a 2-month old infant].

Background: A granulocytosis associated with the use of silver sulfadiazine has been described in burn patients. This agranulocytosis may be due to either an allergic reaction or a bone marrow toxicity by silver sulfadiazine.

Case Report: A 1-month old baby was hospitalized in pediatric intensive care unit after a stage one repair of a tracheoesophegeal fistula.

[Current aspects of acute respiratory distress syndrome in children].

Acute respiratory distress syndrome (ARDS) is a frequent condition in pediatric intensive care units. The mortality remains high despite advances in conventional mechanical ventilation and aetiological treatment. Several animal studies have documented lung injury during mechanical ventilation with high tidal volume, and clinical investigations have shown that in human ARDS, most ventilation is distributed to the small areas of remaining aerated lung resulting in overdistension of these areas and lung injury ("baby lung" theory).

[Basedow disease following metastatic thyroid cancer].

Objectives: Metastatic thyroid carcinoma rarely provokes hyperthyroidism. We describe here the main characteristics of this association observed in a 48-year-old woman.

Case Report: The patient had presented signs of hyperthyroidism for one year.

Medical treatment of congestive cardiac failure from cerebral arteriovenous fistulas at bicêtre hospital.

Arteriovenous fistulas create an increase in venous return and subsequent right heart overload. The result is right heart dilatation, pulmonary arterial hypertension, and increased pulmonary blood flow. Reduction in arterial diastolic pressure (as observed in arteriovenous shunt), an increase in end diastolic pressure (due to increased preload), a reduction in diastolic period (due to tachycardia) are all detrimental to myocardial perfusion and hence oxygen delivery and may precipitate left ventricular failure.

[Diabetes insipidus disclosing metastasis of breast adenocarcinoma].

We are reporting on a case of diabetes insipidus (DI) and anterior pituitary failure revealing a breast cancer metastasis. Ten years after being diagnosed with a unilateral breast cancer, the patient presented with asthenia, thirst, polyuria and nocturia improved by subcutaneous DDAVP. MRI revealed a thickened pituitary stalk.

[Abdominal neuropathy of motor expression of diabetic origin. Apropos of a case].

Authors report a case of diabetic truncal neuropathy presenting as a painful abdominal swelling. This entity, which frequently is probably under estimated, may mimic abdominal visceral pathology and patients may be subjected unnecessary to extensive diagnosis procedures.