[Obtain best usage of meropenem dose in severe infections. Results of an observational multicenter study].

Objective: To describe the effectiveness and tolerability of the dose adjustment of meropenem in empirical treatment of nosocomial infections in critically-ill patients admitted to intensive care medicine services.

Methods: Prospective, observational and multicenter study in patients admitted to 17 intensive care medicine services with nosocomial infection, who were initially treated with meropenem, 1 g every 8 h, were eligible. The initial dose was adjusted to 0.

Candida endophthalmitis in non-neutropenic critically ill patients.

Six non-neutropenic critically ill patients who developed hematogenous endophthalmitis due to Candida spp. were studied prospectively. In all cases the yeast was isolated in blood cultures.

[Intensified insulin therapy in the management of gestational diabetes].

A total of 35 pregnancies in 28 Pregestational Diabetic Patients (PDP) were followed with the goal of achieving and maintaining near normoglycemia (as many pre-postprandial glycemias as possible between 60-140 mg/dl); 13 patients (16 pregnancies) were assigned to Subcutaneous Continuous Preprogrammed Insulin Infusion (SCII) because of high risk pregnancies (HRP) (at least one of the following: former history of spontaneous abortions, stillbirths, premature deliveries and/or sterility). The remaining 12 PDP's (15 pregnancies with no past history of the above nature) were treated with Multiple Conventional Insulin Injections (MCII). Both groups were comparable regarding the following clinical parameters: age, time of onset and class of diabetes.

[Treatment of Ewing's sarcoma by radiotherapy and adjuvant chemotherapy : results at 3 and 5 years (author's transl)].

The local treatment of Ewing's sarcoma by radiotherapy is classically linked to a very poor prognosis : 10 to 15% of 5 years survival, 75 to 95% of distant metastasis in 2 years. The combination of local radiotherapy to a systemic adjuvant chemotherapy have been recently shown to give a real benefit to this prognosis. The therapeutic trial of the EORTC and GETO, presented here allows us to hope a disease free survival at 5 years for 50% of our patients and a complete survival at 5 years for 56% of them.

[Multiple primary malignant melanomas. A report of five cases (author's transl)].

The authors present 5 cases of primary malignant melanomas occurring simuatlneously or successively, diagnosed at Institut Gustave Roussy over a period of 10 years. This work emphasizes the need for searching possible changes of nevi in melanoma patients.

[The risk of hemorrhage versus the thromboembolic risk in patients with prosthetic valve].

376 adults were followed up for between 2 and 153 months after surgery (mean: 3.8 years); all of them, with the exception of 8, received anticoagulant treatment. The results were subjected to statistical analysis using several tests.

Results of a randomized clinical trial of preoperative irradiation versus postoperative in treatment of tumors of the hypopharynx.

Preoperative radiotherapy vs postoperative radiotherapy in the management of patients with primary tumors of the hypopharynx was evaluated by a prospective, randomized clinical trial. A statistically significant difference (p less than 1%) existed in favor of postoperative radiotherapy relative to survival rates, complications, and quality of survival. The postoperative radiotherapy group showed a 56% 5-year survival rate compared to 20% in the preoperative radiotherapy group.

Modes of invasion of cancer of the larynx. A statistical, histological, and radioclinical analysis of 120 cases.

A statistical comparison between histologic and radioclinical data was performed on a series of 120 cases of total laryngectomies in order to study the modes of invasion of laryngeal cancer and to quantify the differences of results as evaluated by pathological and by clinical examinations. The first part of this study deals with the spread of cancer depending on its site of origin; the second part examines spread regardless of the primary location of the laryngeal tumor. The comparative results show that it was difficult to determine the deep invasion of structures such as the preepiglottic space and the cartilages from the radioclinical examination, especially in cases of cancer developed on a laryngocele.

[Results of a hemodynamic study of valve diseases surgically treated with prosthesis].

The haemodynamic status after valve replacement surgery and the preoperative haemodynamic parameters have been studied for their predictive value in a series of 217 patients who have had aortic, mitral or mitro-aortic valve replacements; all cases had a preoperative catheterisation, and 132 had a postoperative catheterisation at an average of 15 months postoperative. The following conclusions have been drawn from the study: 1. The operation (which consisted of replacement with a Starr valve with Silastein ball-valve in 8 cases out of 10) resulted in a substantial, and statistically significant, improvement in the minor circulation pressures and in the cardiac index.