Carpal tunnel syndrome: clinical and electrologic forms. Results after neurolysis (88 cases)

Eighty-eight neurolyses of the median nerve in the carpal tunnel were performed. Clinical, anatomical and electrological characteristics allowed to classify the carpal tunnel syndromes in painful and dysesthesial type, in types with progressive (electromyographical, clinical, complete, incomplete) or acute hand muscle atrophy. After neurolysis, clinical and electrological results were analysed and correlated with initial severity of the chronic median nerve entrapment in the carpal tunnel.     

Influence of hypophysectomy, castration, fasting, and spermiation on SBP concentration in male rainbow trout (Oncorhynchus mykiss).

The influence of different experimental and physiological conditions on sex steroid binding protein (SBP) concentrations in the blood (and in hepatic and testicular cytosols) has been studied on male rainbow trout. SBP was measured with a specific binding assay. The aim was to further understanding of regulation of the SBP and in particular to determine the respective influences of reproductive and metabolic status. Twelve days after hypophysectomy, pituitary and steroid hormones were dramatically decreased and SBP concentrations were significantly lowered in blood (-32%) and in hepatic cytosol (-46%) while the binding protein concentration remained constant in testicular cytosol. Castration of maturing animals did not influence SBP concentration in blood and liver cytosol. Toward the end of the reproductive cycle, a dramatic decrease (-80%) of plasma SBP concentration occurred that appears independent of androgen changes that take place during this period, but is concomitant with a rapid increase of plasma growth hormone (GH) levels (and possibly secondary to a natural arrest of food intake). Long-term fasting that increases endogenous GH but decreases plasma IGFs (insulin-like growth factors) concentrations also induces a limited but significant decrease in SBP concentration. Treatment of intact control trout with recombinant bovine GH (1 microgram/g wt, twice a week, for 6 weeks) increased plasma IGF concentrations but did not significantly increase SBP levels. These results suggest that in mature male trout, testicular androgens have little or no influence on SBP regulation. GH levels or liver GH responsiveness and IGF might be involved in SBP regulation. This would, in part, explain the large decrease in SBP around spermiation in trout.     

Prognostic factors of the uterine cervix adenocarcinoma

Background: Prognosis factors for adenocarcinoma of the uterine cervix after primary treatment are poorly established. Methods: A retrospective study of 45 cases of adenocarcinoma of the cervix with a follow-up of 96 months on average was performed. The primary treatment consisted in combined radical surgery and radiotherapy for stage I-II patients while patients with advanced disease were treated by radiotherapy. In case of poor prognosis factors, they were given chemotherapy. Survival rates were established and prognosis factors influencing survival and recurrences were studied. Results: Fifteen women remained alive without evolutive disease. FIGO stage and pelvic node involvement were the most important parameters influencing overall survival. Local failures (27%, average period of 30 months) were unpredictable and led to a dramatic outcome. Histological grade and pelvic node status were significant predictive factors for metastatic recurrence (40%, average period of 29 months). Conclusions: Local recurrence and metastatic dissemination of cervical adenocarcinoma after primary treatment prove to be rapidly fatal although life expectancy can be prolonged with adjuvant treatment of the recurrence. In the event of aggressive tumors with high histological grade and pelvic node involvement, an attempt to assess adjuvant systemic chemotherapy could be useful.     

FibroScan used in street-based outreach for drug users is useful for hepatitis C virus screening and management: a prospective study

Summary.  Although hepatitis C virus (HCV) infection prevalence is high among drug users, they do not commonly receive regular care in academic centres. The aim of this prospective study was to assess the influence of FibroScan use on HCV screening and management in street-based outreach. From January 2006 to January 2007, all consecutive drug users were offered noninvasive evaluation of liver fibrosis with FibroScan. After FibroScan, parameters were recorded with a structured, face-to-face questionnaire by outreach workers. All 298 subjects accepted FibroScan evaluation drug use was – ever injected heroin (69%), ever snorted or injected cocaine (89%), current chronic alcohol abuse (44%). The median FibroScan score was 5.3 kPa. Before blood sampling, 34% of subjects reported HCV positivity. HCV positivity was found in 83 cases. All these subjects had positive HCV-RNA. Forty-five subjects agreed to meet a hepatologist. By multivariate analysis, never snorted cocaine, consumed alcohol < 21 drinks per week, duration of injected heroin > 7 years, and FibroScan > 7.1 kPa were significantly associated with HCV positivity. Thus in a street-based outreach service for drug users, the acceptance of FibroScan is excellent. FibroScan with a hospital-based physician may facilitate screening and management of drug users for HCV infection.