Mature cystic teratoma of the fallopian tube. A case report

Primary teratomas of the fallopian tube are extremely uncommon. To date, only about 50 cases have been reported in the literature. They occur usually in the fourth decade. There association with nulliparity and reduced parity has been noted. Many have been discovered incidentally and none has been diagnosed preoperatively. The majority are cystic, show great variation in size and are commonly located in the ampulla or the isthmus. They can be intraluminal, attached to the serous surface by a pedicule and rarely intramural. Histologically they are similar to teratoma of the ovary and elsewhere. We describe a mature cystic teratoma of the fallopian tube found incidentally in a 35-year-old woman operated for suspicion of ectopic tubal pregnancy. The feature of benign teratoma of the fallopian tube is discussed.     

Posterior sternoclavicular dislocations

The frequency of posterior sternoclavicular dislocations represents 0.019% of the shoulder injuries in the Centre of Traumatology and Orthopedics of Dakar. The posterior form is 0.033% compared to the anterior form. The authors report the cases of posterior sternoclavicular dislocations, occurred with seven men and one woman. Seven of these dislocations were located on the left side, including one case of polytraumatism, one associated with a brachial plexus compression, and one case with a fracture of the kneecap. The authors show the interest of the incidence of Heinig in the diagnosis. The open treatment following the technique of burrows which uses the tendon of the subclavius gives satisfactory results in both functional and anatomical respects. They discuss the orthopaedic methods and insist on their disadvantages, especially in the event of vascular lesion with a risk of haemorrhage of a clogged breach or source of instability, and the difficulty of radiological control after reduction.     

Interference of tobacco smoke with immunochromatography assay for urinary drug detection

BackgroundThis study aimed to evaluate the interference of tobacco smoke on immunochromatography assay of urinary drug detection.MethodsOur study included 256 voluntary subjects (143 passive smokers and 113 current smokers). Cotinine was measured by immunoenzymatic method and thiocyanates (SCN^?) by selective electrode. Urinary drug was detected by immunochromatography assay. A positive result is completed by an analytical method with an immunometric assay.ResultsFalse positive results for benzodiazepines are significantly more frequent in smokers compared with passive smokers (90.2% Vs 22.4%; χ² = 116.62, p < 10^?3). For smokers, the number of cigarettes was significantly higher in subjects with falsely positive results for benzodiazepines compared with subjects with negative results (32 ± 11 Vs 20 ± 10; p = 0.04). Between these two groups, we established a significant difference for urinary cotinine (345 ± 211 Vs 117 ± 54 μg/μmol; p < 10^?3) and for plasma SCN^? (101.6 ± 3.4 Vs 98.8 ± 2.1 μmol/L; p = 10^?3). Urinary cotinine and consumption duration present the highest values of areas under curves (AUC) of the receiver-operating-characteristic (ROC) curves. The cut-off of 167.6 μg/μmol and 10.5 years were found as predictive factors of false positive results.ConclusionTobacco smoke interferes with immunochromatography assay of urinary drug detection; therefore, all subjects must be questioned about their smoking status to avoid such false results during results interpretation.     

Profile of sight‐threatening infectious keratitis: a prospective study

Purpose: To prospectively study patients presenting with sight‐threatening corneal ulcers with a view to identify the predisposing factors, causative organisms, clinical signs and treatment outcomes. Methods: Prospectively, over 3‐year period, all cases with serious infective keratitis presenting to Queens Medical Hospital in Nottingham, UK, were recruited. Detailed information on the aetiology, culture results, signs & symptoms, the treatment given and the patient’s response was collected and statistically analysed. Results: One hundred and forty‐three eyes of 129 patients were enrolled. Thirty‐one patients were managed as out‐patients, and 98 were treated as in‐patients. The mean duration of admission was 9 ± 13 days but was significantly higher in older patients and in Acanthamoeba keratitis cases. The important risk factors were ocular surface disease (32%), contact lens wear (26%) and previous ocular surgery (20%). Old age, deep infiltration, steroid use and poor initial vision were risk factors for prolonged course of treatment in bacterial keratitis. Corneal scrapings were done in 89% of the cases, but positive results were obtained only in 41.7%. Staphylococcus aureus was the most common isolated bacteria (18.8%). Acanthamoeba and Pseudomonas aeruginosa were the second and third common causative organisms (16.6% and 15%, respectively). Overall, 8.3% needed corneal grafting, which survived in 83.3% and eradicated infection in 100%. Conclusion: Microbial keratitis is an important cause of ocular morbidity. Previous ocular disease is an important predisposing factor. Old age, steroid use and poor presenting visual acuity are important prognostic indicators. Corneal grafting is an effective option for managing recalcitrant corneal infections.