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Every year in France, nearly 50 infants live in a prison nursery with their mother. According to French law, infants can live with their mother in the prison nursery until they reach 18 months of age. The international community is concerned about the lack of validated social, medical and legal data on these infants living in prison. This was a retrospective and descriptive study. Medical and paramedical files of the General Council of Île-et-Vilaine, France, were studied. Every infant born between 1998 and 2013 while their mother was in prison were included. Fifty-four files were collected. The average length of stay was 6.2 months (n=54). The type of the mother's prison sentence was property damage in 40 % of cases, personal injury in 51.1 % of cases and both in 8.9 % of cases (n=45). The length of the mother's imprisonment was on average 45 months, ranging from 3 to 216 months (n=34). After prison, 42.9 % of the infants were placed in foster care and 57.1 % resided with their family (n=42). This child-mother incarceration could be an opportunity for positive intergenerational paramedical, medical and social services. The lack of data and problems collecting data restrict our knowledge of these families. This should motivate a national follow-up for these children.

Aims: We tested whether brain event-related potentials (ERPs) are normal in children with congenital hypothyroidism (CH) after early high-dose levothyroxine treatment. Methods: Auditory ERPs were recorded in 33 normal controls and in 15 children with CH at 5 years 9/12. Based on bone maturation at diagnosis, the CH group was divided into severe (n = 8) and moderate (n = 7) subgroups. CH patients were treated at a median age of 14 days with a mean initial dose of levothyroxine of 11.6 µg/kg·day. Two ERP components (N100 and N200) were measured and clinical follow-up variables collected. Results: The functional anatomical and cognitive organisation of the auditory system, as revealed by the analyses of ERP measures, did not differ between CH and controls, or between severe and moderate CH subjects. However, N200 latency was globally longer in the CH than in the control group (p = 0.01) and was positively correlated with the over-treatment index (r = 0.61; p < 0.05) and verbal IQ. N200 amplitude was negatively correlated with initial dose (r = –0.74; p < 0.005). Conclusion: These data suggest that sensitive tools such as ERPs can reveal differences between CH and controls and relate these differences to the adequacy of treatment of CH.

Advances in endourology have significantly reduced indications of open surgery in the treatment of staghorn calculi. However, in our experience, open surgery is still the treatment of choice in some cases. This study presents the results of a series of selected patients and discusses the results in terms of efficacy and morbidity.A cohort of 26 patients underwent anatrophic nephrolithotomy by lombotomy to treat a complex staghorn calculus.The mean stone size was 68,5mm, 70% were complete staghorn calculi. The operative time was 100minutes. Blood loss was 225mL, with a postoperative transfusion rate of 15.4%. The hospital stay was 8.4 days. The stone free rate following the procedure was 92%. The creatinine clearance (MDRD) at 3 months was improved from 5.9mL/min/m(2) on average over the entire series.There are clearly still indications for open surgery in staghorn stones management, with good results in this contemporary series on both stone removal and nephronic preservation. Yet, it appears that this technique is no longer taught.5.

Hurler syndrome, the most severe form of mucopolysaccharidosis type I (MPS I), is a rare lysosomal storage disease. The overall incidence of MPS I is 0.99-1.99/100,000 live births. Accumulation of glycosaminoglycans causes the progressive dysfunction of multiple organs. We report the case of a 3-week-old newborn who was hospitalized in the Neonatal Intensive Care Unit for feeding problems. Coarse facial features and gingival hypertrophy, associated with axial hypotonia, upper airway obstruction, and moderate hepatomegaly, led to the early diagnosis of MPS I at 3 weeks of age and was confirmed by an abnormally elevated amount of dermatan and heparan sulphate in the urine and complete deficiency of alpha-L-iduronidase lysosomal enzyme activity. The child was homozygous for the p.W402X mutation, located on chromosome 4p16.3 of the alpha-L-iduronidase (IDUA) gene. The clinical condition gradually deteriorated until the age of 4 months, with thoracic and lumbar dysostoses, glaucoma, cerebral ventricular dilatation and cervical spinal stenosis, dilated cardiomyopathy, and umbilical hernia. Early diagnosis allowed enzyme replacement therapy (iaronidase, Aldurazyme(®), Genzyme) started at the age of 5 months, which provided stabilization of the heart disease, significant regression of rhinologic symptoms, and regression of hepatomegaly. Cord blood hematopoietic stem cell transplantation was performed at 11 months of age, allowing optimal preservation of cognitive development.

The current French hospital reform is based on the disease-related group (DRG) approach and the constitution of bigger units pooling several departments of different specialties. This reform needed an efficient assessment of various medical activities. We report our experience of a medical table of our hospital activities used for 27 months. This medical table was made with a basic software integrating 24 parameters. The original concept was the translation of the specific final diagnosis for DRG defined by the site of infection. To create this medical table, we first simplified the conclusions of the patient's chart using a consensual and systematic plan. The number of patients per DRG and their evolution were therefore specifically determined. The medical table helped us in the daily management of our department, to identify the area of recruitment, the potential for heterogeneous care, allowing the implementation of protocols and their applications. Moreover, the table quantified morbidity and mortality, indicating our need for cooperation with other departments. All this data used medical-lexical terms, allowing other than economic analyses, even if this table identifies hospitalization-related costs, namely duration of hospital-stay, nosocomial infections and iatrogenic events. Finally, our table supports medical research and evaluation of practice. Our future goals are to introduce this table in several infectious-diseases units, and create specific tables for the main RDG, including economic parameters.

The aim of this study was to determine whether eye length measurements obtained with the IOL Master (Zeiss Humphrey) before and after phakic IOL implantation would show any changes.In a prospective study, we used the IOL Master to measure optical biometry in 25 myopic eyes of 15 patients before and after phakic IOL implantation (PRL, ICL, Artisan). The differences between both axial length measurements were calculated and compared using a nonparametric Wilcoxon test.The difference between the preoperative and postoperative measurements ranged from -0.16 mm to 0.06 mm and averaged -0.016 mm, which was not statistically significant (p=0.20). Both measurements correlated in a highly positive manner (r=0.999; p0.0001). The reproducibility of the preoperative and postoperative axial length measurements was very high (coefficient of variation=0.09% and 0.07%, respectively). The precision was 26 microm for preoperative measurements and 19 microm for postoperative measurements.Our results showed that postoperative measurements of axial length are highly comparable to preoperative measurements and that optical biometry can achieve highly precise and reliable axial length measurements in eyes with phakic IOLs. This application becomes clinically relevant in evaluating eyes with phakic IOLs that might require cataract surgery. Hence, accurate axial length measurements in eyes with phakic IOLs will be extremely important when cataract occurs in these eyes and when the preoperative measurements are no longer available.

We present two cases of persons wearing hard contact lenses resulting in corneal modifications which could have falsified the indications for LASIK.In the first case the use of hard contact lenses led to thickening of the cornea which might have led to an erroneous indication for LASIK and an excessive thinning of the cornea. In the second case, the shape of the cornea was modified and the rigid lens masked a subclinical keratoconus.Since corneal ectasia is the major complication of LASIK surgery due to excessive thinning of the cornea or LASIK surgery on an undiagnosed keratoconus, these two cases illustrate the importance of a pre-LASIK eye examination for patients wearing hard lenses several weeks after these contact lenses have been discontinued.

The aim of this study was to analyse the tolerance of Myopic Anterior Chamber IOL's 8 years after surgery.We have studied 21 eyes implanted with an anterior chamber phakic IOL between May 1989 and June 1990. The 21 eyes had a very high myopia (mean pre-operative myopia--13.5 Dipters). Surgical technique was easy, without peroperative complications.Post-operative refractive results were excellent with a mean refraction of -0.25 D. Post-operative complications were a pupillary ovalisation in 42% of the eyes and glare in 50% of the eyes. Specular microscopy was normal pre-operatively for all the eyes but at 8 years, 4 (19%) of the eyes have had a strong loss of their endothelial cells and have to be explanted. Decreasing of endothelial cells is the most severe complication occurring after Phakic anterior chamber myopic IOL implantation.These 21 Myopic Anterior chamber IOL's have given a very good refractive result for all the eyes. 4 (19%) of the eyes operated on with these IOL's had a decreasing of their endothelial cells and the IOL had to be removed. Rigourous follow-up of the implanted eyes is required.

To determine the tolerance of the corneal endothelium and of the haemato-ocular barrier of phakic highly myopic eyes implanted with an anterior chamber I.O.L.ses.Twenty-one phakic highly myopic were operated on with a Z.B.A.C.I.O.L. (manufactured by Domilens) by the same surgeon from May 1989 to June 1990. Complete examination including specular microscopy have been performed before surgery and each 6 months and a Laser Flare Cell Meter at 3 years was performed on 14 eyes.Two eyes of the same patient had to be explanted after surgery for important endothelial cell loss. The 19 others had no complication: no cataract, no loss of endothelial cells, no retinal detachment. 14 eyes examined with a Laser Cell Flare Meter had results within normal limits. So, 19 out of 21 eyes implanted for high myopia with Z.B.A.C.I.O.L. have excellent results 4 years after surgery.Regarding these results, it seems possible to use this technique again with the new designed Anterior Chamber I.O.L.. Rigorous follow-up of all the implanted eyes is however required.

We present our experience with 63 myopic eyes that had photorefractive keratectomy with an excimer laser. Minimum follow-up was six months. Mean preoperative myopia was -3.98 diopters (D) (range: -9.00 D to -1.25 D) and mean preoperative uncorrected visual acuity, 20/220. The epithelium was removed and fixation accomplished with a suction ring. Photoablation was then performed on a 5.0 mm diameter optical zone. Mean postoperative myopia was -0.60 D (range: -6.35 D to +2.25 D) after six months. Mean uncorrected visual acuity was 20/30. All corneas had a subepithelial haze that decreased progressively. There were no major complications. Except in a few cases, predictability was satisfactory. Photorefractive keratectomy proved effective throughout the trial. We need to study more patients with a longer follow-up to determine the indications and applications of this technique.

This report describes a technique of total intraabdominal laparoscopic gastrectomy using laparoscopic stapling and suturing. The reestablishment of continuity of the upper gastrointestinal tract was performed by gastrojejunostomy (Billroth II) using the Endo GIA stapler. This procedure merits inclusion in the armamentarium of approaches toward surgical treatment of recurrent gastric ulcer.

The so-called R.K. classic technique gives good results for myopias under 5 diopters. We have performed different modifications of the technique for the 8 incisions--optical zone 3 mm R.K. 8 incisions--O.Z. 3 mm. Downhill incision direction or "American technique" incisions (from the O.Z. towards the limbus). 8 incisions--O.Z. 3 mm + a deepening of 20 microns from a 6 mm O.Z. Repeat operations (Stan Franks Backcutting technique or addition of incisions). 8 incisions--O.Z. 3 mm. Uphill incision direction or "Russian technique" (from the limbus towards the optical zone). This study was carried out with 134 R.K. and shows that we get best results for myopias between 5 to 7 diopters, with the last technique (Uphill incision direction).

The X-ray scanning symptoms of dysthyroidal ophtalmopathy are so typical that they are enough to make the diagnosis in most of cases. Their determination through the FEMEN system increases the sensitivity of the method. The investigation of 60 cases of oculomotor palsies with a FEMEN score greater than 10 confirms that they are certainly or probably subsequent to an endocrinopathy in 93% ot the cases.

The survey of a population of 7 patients with malignant glaucoma, whose 3 were bilateral, showed that the total length of these eyes was weaker, the corneal radius shorter, the anterior chamber more shallow and the insertion of the lens more anterior than that of eyeballs with angle-closure glaucoma on the whole. These latter, we must remind, are already smaller than normal eyes. But this lessening of size does not affect the corneal diameter which remains always normal. And the lens, which is greater than normally in the angle-closure glaucoma, in the contrary is normal or smaller in the malignant glaucoma. The authors think that this little size of the lens allows it to be dislocated anteriorly through the limbal ring after the operation, and so is the cause of the post-surgical malignant glaucoma.

Between April 2003 and March 2005, 113 outbreaks of histomonosis were recorded in standard turkey farms in France, and 15 cases were recorded in turkey breeding centres. Most of the cases were in north-west France, the principal farming area for turkeys. The majority of the cases occurred during the hottest months, from April to September. Large numbers of cases occurred among birds from four to eight weeks of age, but there were some cases in three-week-old birds and some in birds up to 17 weeks of age. In most of the standard turkey flocks the mortality was less than 10 per cent, but it was above 30 per cent in nearly 20 per cent of the outbreaks. In the breeding flocks, the average mortality was 60.2 per cent. The size of the flocks, the sex of the birds and the age at which the first clinical signs appeared did not seem to influence the mortality.