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Introduction: To describe patients admitted to a geriatric institution, providing short-term hospitalizations in the context of ambulatory care in the canton of Geneva. To measure the performances of thisstructure in terms of quality ofcare and costs., Method: Data related to the clinical,functioning and participation profiles of the first 100 patients were collected. Data related to effects (readmission, deaths, satisfaction, complications), services and resources were also documented over an 8-month period to measure various quality and costindicators. Observed values were systematically compared to expected values, adjustedfor case mix., Results: Explicit criteria were proposed to focus on the suitable patients, excluding situations in which other structures were considered to be more appropriate. The specificity of this intermediate structure was to immediately organize, upon discharge, outpatient services at home. The low rate of potentially avoidable readmissions, the high patient satisfaction scores, the absence of premature death and the low number of iatrogenic complications suggest that medical and nursing care delivered reflect a good quality of services. The cost was significantly lower than expected, after adjusting for case mix., Conclusion: The pilot experience showed that a short-stay hospitalization unit was feasible with acceptable security conditions. The attending physician's knowledge of the patients allowed this system tofocus on essential issues without proposing inappropriate services.

Post-traumatic ptosis may be classified as follows: ptosis occurring during lid avulsion, ptosis associated with fractures of the orbital roof and with foreign bodies, post-contusional ptosis, cicatricial ptosis, neurogenic ptosis and post-surgical ptosis. The patient must be thoroughly examined, including examination of the eye-ball, extra-ocular muscles, eyelid and evaluation of upper eyelid levator function and orbital and facial examination. The various surgical methods proposed include levator muscle surgery, aponeurotic surgery, Müller's muscle surgery and frontalis suspension surgery. Surgical indications and choice of surgical method essentially depend on the anatomo-clinical forms. The general rule is to operate under local anesthesia to obtain better control of the muscular function. Some cases are simple to treat such as post-contusional ptosis with good levator function which allows functional surgery with excellent static and dynamic results. Other relatively simple cases with non functional levators may only be treated on a static basis. Last but not least are more difficult cases in which levator function is difficult to evaluate pre-operatively because of severe fibrosis. The aim in such cases is to explore the eyelid by an anterior approach under local anesthesia and to propose either muscular surgery or a frontalis suspension according to the anatomical and functional status of the levator muscle.

The outcome of infants born to HIV1 seropositive (HIV1+) mothers is still uncertain is spite of current progress in techniques for viral detection. Using the almost elective tropism of HIV1 virus for CD4 lymphocytes and the central role of these cells in the immune regulation, we studied blood lymphocyte populations with 7 monoclonal antibodies during the first month of life in 28 newborns of HIV1 seropositive mothers. Our data are compared to an age-matched population of 35 control infants. According to our results, the coexistence of a low CD8 lymphocyte percentage together with a high CD4/CD8 ratio seems to be correlated with an unfavourable outcome.

Presentation of 42 glial idiopathic epiretinal macular membranes, surgically removed. Complications are rare. The functional improvement is greater if the operation is carried out when the visual acuity is low but the final result is better if eyes are operated when the visual acuity is still good. The main difficulties are the impossibility to detach the membrane, and the iatrogenic tears, which often need an internal tamponade by intraocular silicone oil.