Search

The intramedullary nailing of humerus has emerged as one of the treatments of reference for proximal fractures. We have reviewed 38 patients aged 64.2 on average with a mean follow of 18 months. The functional scores used were the Constant and Murley's score as well as the DASH self-administered quality of life questionnaire. Radiological criteria have been analyzed, namely the cephalic angle noted alphaF and the presence of any osteolysis of the major tuberosity. Patients were grouped by type of fracture, according to Neer's classification, with nine cases in Neer 2 group, 19 in Neer 3 group, and ten in Neer 4 group. The unrefined Constant score was 53.4 points on average, balanced to 71.6%. The joint mobilities were an average forward elevation of 108 degrees, an average abduction of 100 degrees and an external rotation of 27 degrees. These scores were even worse than the fracture was comminuted. It was not found a radioclinical correlation between value of the angle alphaF and clinical outcome, but the presence of osteolysis of the major tuberosity was significantly associated with poor late functional results. Five cases of osteonecrosis have been counted, divided with 10.5% in the Neer stage 3, and 30% in the Neer stage 4. The average unrefined Constant score from these patients was 38.5 points on average, balanced to 57.7%. Intramedullary nailing allows fixation of comminuted fractures with three or four fragments, but control of fixing and strength of assembly were not always practiced. In young patients, where tuberosities consolidation is essential, screwed plates seem to be a favorable alternative. Moreover, total reverse prosthesis seems to have more and more arguments to impose itself like the preferred treatment towards fractures in four fragments in people aged over 75 years., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)

Changes in lipid plasma levels during malaria attacks have been proposed for use in diagnosis or to assess the severity of the disease. In order to analyse the plasma levels of cholesterol, triglycerides, HDL-C et LDL-C, we compared, in an endemic area (São Tomé island), two groups of patients children infected with Plasmodium falciparum (simple malaria attack and cerebral malaria) with a control group of asymptomatic children. No correlation between lipid plasma levels and disease severity was found. Correlations between lipids and parasitemia or anemia were analysed. The mechanism of plasma lipid changes during attack are discussed.

An enzyme-linked immunosorbent assay with larval stage antigen was used to measure the concentration of antibodies to Toxocara sp in 2206 human sera. The results led to the determination of the specificity of our method, the experimental cutoff estimation and the Toxocara sp seroprevalence in different human populations. The prevalence of canine toxocariasis in pet dogs and the associated environmental contamination were studied through examination of 107 faecal and 20 sand-pits samples for Toxocara sp eggs. Our immunological studies and environmental research revealed the existence of toxocariasis as a zoonotic disease in Belgium. We compare here our results with those found in the world literature: in spite of some surprising results, the environmental factors are important for toxocaral infection. The urban residence, the restricted number of playgrounds for children and areas for dogs, the socioecological status are preponderant in the spread of infection.