Does stoma modify compliance with enhanced recovery after surgery programs? Results of a cohort study

PURPOSE

Few studies have focused on enhanced recovery programs (ERPs) in patients who have received a stoma after colorectal surgery. The objective of the study was to compare ERP compliant patients who have not received a stoma, those who received a colostomy, and those who received an ileostomy.

METHODS

This study used data that had been prospectively collected as part of the ERP audit performed through the Groupe francophone de Réhabilitation Améliorée après Chirurgie [Francophone Group for Enhanced Recovery after Surgery] over a 4-year period. All patients who had undergone colorectal surgery were included and separated into three groups (no stoma, ileostomy, and colostomy). The primary outcome was ERP compliance, calculated through the use of 16 tracer items.

RESULTS

Of the 422 recruited patients, 317 had not received a stoma (75.12%), 59 had an ileostomy (13.98%), and 46 had a colostomy (10.90%). ERP compliance was 73% in the non-stoma group, 66.6% in the ileostomy group, and 66% in the colostomy group (p < 0.001). Multivariate analysis showed that patients from the ileostomy group had a higher risk of bowel preparation [OR = 9.1; 95% CI = 1.16-71.65] and of maintaining their urinary catheter [OR = 0.3; 95% CI = 0.14-0.81] than the group which did not receive a stoma. Patients from the colostomy group required significantly more drainage than those in the non-stoma group (OR = 4.3; 95% CI = 1.33-14.02).

CONCLUSION

ERP is feasible in colorectal surgery in the context of stomas, but in case of ileostomy protecting a rectal surgery, the audit system must be adapted to the protocols in use in the departments.

Acute urinary retention and urinary tract infection after short-course urinary drainage in colon or high rectum anastomoses: Post hoc analysis of a multicentre prospective database from the GRACE group

AIM

The aim was to define the risk factors for acute urinary retention (AUR) and urinary tract infections (UTIs) in colon or high rectum anastomosis patients based on the absence of a urinary catheter (UC) or the early removal of the UC (<24 h).

METHOD

This is a multicentre, international retrospective analysis of a prospective database including all patients undergoing colon or high rectum anastomoses. Patients were part of the enhanced recovery programme audit, developed by the Francophone Group for Enhanced Recovery after Surgery, and were included if no UC was inserted or if a UC was inserted for <24 h.

RESULTS

In all, 9389 patients had colon or high rectum anastomoses using laparoscopy, open surgery or robotic surgery. Among these patients, 4048 were excluded because the UC was left in place >24 h (43.1%) and 97 were excluded because the management of UC was unknown (1%). Among the 5244 colon or high rectum anastomoses patients included, AUR occurred in 5.2% and UTI occurred in 0.7%. UCs were in place for <24 h in 2765 patients (52.7%) and 2479 did not have UCs in place (47.3%). Multivariate analysis showed that management of the UC was not significantly associated with the occurrence of AUR and that risk factors for AUR were male gender, ≥65 years old, having an American Society of Anesthesiologists score ≥3 and receiving epidural analgesia. Conversely, being of male gender was a protective factor of UTI, while being ≥65 years old, having open surgery and receiving epidural analgesia were risk factors for UTIs. The management of the UC was not significantly associated with the occurrence of UTIs but the occurrence of AUR was a more significant risk factor for UTIs.

CONCLUSION

UCs in place for <24 h did not reduce the occurrence of AUR or UTI compared to the absence of UCs.

Estimates of Maize Plant Density from UAV RGB Images Using Faster-RCNN Detection Model: Impact of the Spatial Resolution

Early-stage plant density is an essential trait that determines the fate of a genotype under given environmental conditions and management practices. The use of RGB images taken from UAVs may replace the traditional visual counting in fields with improved throughput, accuracy, and access to plant localization. However, high-resolution images are required to detect the small plants present at the early stages. This study explores the impact of image ground sampling distance (GSD) on the performances of maize plant detection at three-to-five leaves stage using Faster-RCNN object detection algorithm. Data collected at high resolution (GSD ≈ 0.3 cm) over six contrasted sites were used for model training. Two additional sites with images acquired both at high and low (GSD ≈ 0.6 cm) resolutions were used to evaluate the model performances. Results show that Faster-RCNN achieved very good plant detection and counting (rRMSE = 0.08) performances when native high-resolution images are used both for training and validation. Similarly, good performances were observed (rRMSE = 0.11) when the model is trained over synthetic low-resolution images obtained by downsampling the native training high-resolution images and applied to the synthetic low-resolution validation images. Conversely, poor performances are obtained when the model is trained on a given spatial resolution and applied to another spatial resolution. Training on a mix of high- and low-resolution images allows to get very good performances on the native high-resolution (rRMSE = 0.06) and synthetic low-resolution (rRMSE = 0.10) images. However, very low performances are still observed over the native low-resolution images (rRMSE = 0.48), mainly due to the poor quality of the native low-resolution images. Finally, an advanced super resolution method based on GAN (generative adversarial network) that introduces additional textural information derived from the native high-resolution images was applied to the native low-resolution validation images. Results show some significant improvement (rRMSE = 0.22) compared to bicubic upsampling approach, while still far below the performances achieved over the native high-resolution images.

Drugs Effect on Platelet Survival Time: Comparison of Two Pyrimido-Pyrimidine Derivatives in Patients with Aortic or Mitral Replacement

A prospective randomized trial of the effects of 2 antiplatelet aggregating drugs, dipyridamole (375 mg/d), a related substance RA 233 (1500 mg/d) and placebo, concomitantly with oral anticoagulants, was carried out in patients with prior valvular replacement. The study was aimed to determine effect on platelet survival time (PST) of these 2 agents. The trial sample consisted of 40 males and 15 females aged 40–70 years (average 53 years). 32 received Björk-Shiley valve in aortic position; 23 underwent mitral valve replacement: 3 with Cooley-Cutter, 11 with Lillehei- Kaster 500 and 9 with Starr-Edwards 6120 prostheses; 28 patients had aortic stenosis, 21 aortic insufficiency. All the PST measured after 3 months of treatment were within normal ranges and not different between placebo, dipyridamole or RA 233 treated subjects: averages in days were, respectively, 7.49, 7.11 and 6.88. The present study did not support the claim that modem valve prosthesis could lead to a shortened PST.

[Psychopathological aspects of a child with Klinefelter's syndrome]

The description of a 9 year old boy introduces the discussion about psychopathology and Klinefelter syndrome. This child's profile is not typical. He presents several visuo-spatial impairments and important behaviour deviance. We discuss the connections between biological, psychological and environmental variables in the emergence of such a trouble.

Differential latency testing: a more sensitive test for radial tunnel syndrome

A modification of the standard electrodiagnostic test was developed in an effort to provide a more sensitive electrodiagnostic evaluation in radial tunnel syndrome. Radial motor nerve latency recordings were obtained in 3 different forearm positions: neutral, passive supination, and passive pronation. The maximal difference in these recordings, the differential latency, in 25 patients with radial tunnel syndrome of greater than 6 months duration (test group) was compared with those in 25 asymptomatic volunteers (control group). Differential latency recordings were obtained in all patients in the test group before and after surgery. Radial nerves that were compressed demonstrated a significantly greater differential latency (0.44+/-0.12 ms) versus controls (0.12+/-0.008 ms). Following radial nerve decompression, differential motor latencies in the test group decreased below control values, demonstrating a resolution of the provoked electrical response with a postoperative differential latency of 0.07+/-0.05 ms. Our results demonstrate the differential motor latency of the radial nerve to be a sensitive electrodiagnostic tool in patients with radial tunnel syndrome. A differential latency of > or =0.30 ms was considered indicative of radial tunnel syndrome.

Provocative motor nerve conduction testing in presumptive carpal tunnel syndrome unconfirmed by traditional electrodiagnostic testing

In this controlled prospective study, 22 consecutive surgical candidates with clinically diagnosed CTS and negative findings on median nerve-sensory and motor-conduction velocity tests in both hands were reexamined with a protocol incorporating 5 specific positions of the wrist. Four of the 5 positions represented maximum physiologic ranges of motion for the patient. These positions were neutral (unstressed), extension, flexion, radial deviation, and ulnar deviation. Motor latency was recorded in each of the 5 positions using otherwise standard technique. The least latency value in the test sequence was subtracted from the greatest to yield a value called differential latency. Thirty-two control studies were obtained on both hands of 16 normal volunteers and were used to establish a control differential latency, which was seen to have a mean of .13 ms. A 2 standard deviation z value of .11 ms was calculated, giving an upper limit of normal (control) differential latency of .24 ms. Preoperative studies yielded an average differential latency of .44 ms, with 20 of 22 patients having differential latency values of greater than .24 ms. Evaluations of these same patients 3 months after surgery showed differential latency values within the same range as those of the control group. Simple modification of standard nerve testing techniques to include positional variation increased the yield of positive test results in 20 of 22 patients with CTS whose electrodiagnostic tests otherwise produced negative findings.

Effects of fertilizer on insecticides adsorption and biodegradation in crop soils

Recent organic fertilizer treatments (cow manure, pig slurry, composts, or green manure) simultaneously increase insecticide adsorption onto soil and the insecticide soil persistence, indicating a mechanism of slow release of insecticide into soil by the organic matter. This occurred in sugar beet crops with aldicarb, thiofanox and imidacloprid; also, in leek, cauliflower and brussels sprouts crops with chlorpyrifos and chlorfenvinphos. In contrast, organic fertilizer treatments applied once or repeatedly in the past, have no significant influence on adsorption or persistence of insecticides; the same is observed for the old soil organic matter, when its soil concentrations change in limited ranges

Education program for general practitioners on breast and cervical cancer screening: a randomized trial. PRE.SA.GF Collaborative Group

This study was aimed at evaluating the effects of an education program for general practitioners on their prescribing behaviour for cervical and breast cancer screening tests, and assessing the feasibility of general practitioners participation in screening programs. All three cytology laboratories and 19 of the 20 radiologists in one administrative region ("Haute-Savoie") in France agreed to participate. The 278 general practices in this region were randomly assigned to either the intervention group (a one-day seminar on screening for breast cancer and cervical cancer) or the control group (n for both = 139). The prescriptions of tests for the following year were noted from the laboratories' and radiologists' records. No significant differences were observed between the intervention group and the control group for the number of mammographies prescribed with a mean of 19.3 and 15.2 per practice, respectively. However, significantly more mammographies were prescribed in women aged over 50 by the intervention group (p = 0.038). Inversely, fewer smear tests were prescribed in the intervention group (mean per practice: 40.5 and 46.1, respectively). A significantly higher number of practices in the intervention group did not prescribe any smear tests (p = 0.007). This study suggests that it is possible to influence general practitioners' participation in screening programs, but that the messages should be carefully presented, since negative effects are possible.

A randomized comparison of the effect of four antihypertensive monotherapies on the subjective quality of life in previously untreated asymptomatic patients: field trial in general practice. The OCAPI Study Group. Optimiser le Choix d'un Anti-hypertenseur de Première Intention

OBJECTIVE

To assess the equivalence of four antihypertensive treatments in patients with mild-to- moderate hypertension, and to compare the effects of those drugs on the subjective quality of life and clinical safety.

DESIGN, SETTING AND PATIENTS

653 patients aged > or = 18 years with untreated hypertension were randomly allocated to receive a combination of two diuretics (altizide and spironolactone), a beta-blocker (bisoprolol), a calcium antagonist (verapamil), or an angiotensin converting enzyme (ACE) inhibitor (enalapril). Follow-up lasted for 1 year.

MAIN OUTCOME MEASURES

A composite outcome of the following measures was used to define success: attendance at the 12-month visit; at least nine supine DBP measurements during the study; and median supine DBP < 90 mmHg and a reduction of at least 10 mmHg compared with the baseline value. Failure was defined as one or more of those criteria not being fulfilled. Equivalence was concluded if the 95% confidence interval for the success rates differed between two groups by less than +/- 10%. Clinical safety and subjective quality of life were also assessed.

RESULTS

No statistically significant differences in the change in DBP or systolic blood pressure were observed between the groups. The success rates were 43.9, 42.0, 32.5 and 43.9% in diuretic, beta-blocker, calcium antagonist and ACE inhibitor groups, respectively. Equivalence between the treatments could not be concluded, although analysis with a larger equivalence interval showed that some comparisons indicated equivalence. Significant improvement in satisfaction was observed for certain items for subjective quality of life at 1 month in the calcium antagonist treatment group, and significant differences in the responses to the clinical safety questionnaire were observed after 1-month follow-up in calcium antagonist and beta-blocker groups. Differences were no longer significant after 9 months.

CONCLUSIONS

These results do not provide evidence on the basis of efficacy of blood pressure lowering or ability to increase short-term (1-year) safety and quality of life favouring any particular treatment among the studied drugs for newly diagnosed patients with mild-to-moderate hypertension.

[Drug prescription in the postinfarction period; results of the EPPI II (Study of Postinfarct Prescription). A French cooperative study]

An enquiry into drug prescription of patients discharged from hospital after myocardial infarction was carried out in 27 French hospital departments and included 430 patients. Each patient was prescribed an average of 3.9 drugs. Aspirin was the most widely prescribed drug (79.3%); this was followed by the betablockers (67.4%), long acting nitrate derivatives (42.3%) and calcium antagonists (35.1%). These results, though an improvement compared with those of an enquiry carried out 3 years ago, suggest that much prescription in the post-infarction period is not consistent with our present knowledge.

[Controlled clinical trial and homeopathic treatment of ORL and recurrent respiratory tract infections in children: preliminary survey of homeopathic physicians]

We performed a survey to assess the feasibility of a placebo-controlled clinical trial of the treatment of recurrent ENT/respiratory tract infections in children, to assess the diversity of the drugs prescribed, and the acceptability of a clinical trial to homeopathic physicians. A mailed questionnaire was sent to 237 homeopathic physicians, asking for details of prescriptions for 10 consecutive children consulting for ENT/respiratory recurrent infections, and for two simulated cases. We also asked for their opinion about homeopathic treatment evaluation. Only 48 (20 per cent) questionnaires were returned completed. These gave 309 different acute treatments and 422 different preventive treatments for the 10 consecutive patients and 87 different prescriptions for the simulated cases. A total of 467 different drugs were used. The physicians who replied were favourable to the evaluation of homeopathic drugs, reluctant for the use of a placebo; and they would like to receive training in drug evaluation. Setting up a clinical trial in this field would require specific methodological and logistical adaptations, and a detailed training programme for the homeopathic doctors beforehand.

Epidemiology of viral infections and evaluation of the potential benefit of OM-85 BV on the virologic status of children attending day-care centers

Viral investigations were performed during 4 winter seasons (88/89, 89/90, 92/93, 93/94) in children attending day-care centers (DCCs) in the Rhône Département in eastern France. Over the total observation period of 4 winter seasons, 780 children were screened with a nasal swab for the presence of viruses. Of those, 230 (29.5%) had a positive viral culture. The viruses identified were respiratory syncytial virus (RSV), influenza A and B virus, parainfluenza virus, coronavirus, rhinovirus, adenovirus and enterovirus. During that time, 83 epidemic events in 47 DCC were recorded. A particular virus was judged to be causally related to an epidemic if the identical virus was isolated in > or = 3 children during the same outbreak of respiratory diseases. Thus, in 51 cases (61.4%) of all epidemics, the following viruses were responsible for an epidemic: RSV (n = 23), coronavirus (n = 10) (only during the season of 1993-1994), influenza A virus (n = 6), rhinovirus (n = 4), enterovirus (n = 4), adenovirus (n = 3) and parainfluenza virus (n = 1). Except for the somewhat surprising accumulation of coronavirus epidemics during the winter of 1993-1994, there were only minor seasonal variations from one year to another. As expected, RSV accounted for about one third of all respiratory tract infections in children attending DCCs and was therefore the most important single causative agent. These results are compared with data from children who did not attend a DCC and were cared for in a private practice.(ABSTRACT TRUNCATED AT 250 WORDS)

Risk of infectious diseases in children attending different types of day-care setting. Epicrèche Research Group

This population-based prospective cohort study compared the risk of recurrent infections in children attending family day care (< or = 3 children per family), small (10-20 children) day-care centers (DCCs), and large (> or = 40 children) DCCs. The parents of a total of 1,242 children participated in the study (97% of the families initially contacted). An infectious episode was defined as the acute occurrence of a new symptom lasting for at least 48 h and resulting in specific treatment. Two episodes were counted as such only if they were separated by a symptom-free week. Surveillance was under the responsibility of a nursing director and was similar for all three types of DCCs. During the 8.5-month follow-up period, 3,639 infectious episodes were recorded. Compared to those in family day-care, children attending small DCCs presented a higher risk for > or = 6 total infectious episodes [odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.6-3.7]; > or = 5 upper respiratory tract infections (OR = 2.2; 95% CI = 1.4-3.4); > or = 2 episodes of otitis media (OR = 2.6; 95% CI = 1.0-2.6); > or = 2 episodes of conjunctivitis (OR = 4.1; 95% CI = 2.1-8.2); and > or = 2 episodes of croup (OR = 4.1; 95% CI = 1.6-10.9). The risk for children attending large DCCs was intermediate between those in family day care and those in small DCCs.(ABSTRACT TRUNCATED AT 250 WORDS)

[Group meetings for patient recruitment in clinical trial in pediatrics]

Recruitment of patients in a clinical trial is often difficult and probably more difficult in pediatrics where parents are asked to give the informed consent. In order to recruit infants in a randomized clinical trial we organized group meetings with families (4 to 40 at a time) in order to describe the study procedures: random allocation to treatment or placebo and double blind assessment, and ask them to allow their child to participate. All meetings were conducted by both a pediatrician and a RCT specialist. Parents asked questions about the effects of the drug, the evaluation process and the follow-up procedures. Forty nine % of all eligible infants participated in the study. The success rate was related to franc and open communication with the family, provided by highly qualified physicians.

Drug prescription in young children: results of a survey in France. Epicrèche Research Group

A 8.5-month prospective study was performed in the Rhône area of France to study the incidence of infectious diseases in children in day care, and the qualitative and quantitative aspects of drug prescriptions for young children. The families of 1.359 children agreed to participate (98.5% of those selected). During the follow-up period 3.605 infections episodes were reported and 10.706 medications were used, an average of 3.0 medications per episode. Antibiotics were used in the treatment of 2.333 infectious episodes (65%) amoxycillin (36%), cephalosporin (23%), macrolide (17%) and trimethoprim-sulphamethoxazole (9%). Acetylsalicylic acid and paracetamol were used 865- and 1.568-times, respectively. Drugs with multi-active components represented 11.3% of the total number of systemic medicines reported. Paracetamol was prescribed in 59% of cases in a multi-active component drug, whereas this type of product accounted for 83.5% of the antihistamines (used 932-times). The rationale behind the paediatric prescribing habits of French medical doctors is discussed in relation to results previously obtained in other European countries.

[Drug prescription in myocardial postinfarction: results of the EPPI (étude de prescription postinfarctus). A French cooperative study]

An enquiry into the prescribing behaviour in patients discharged from hospital after myocardial infarction was performed in 36 hospital departments in France and included 528 patients. Each patient was prescribed an average of 3.6 drugs. The most commonly prescribed drug was Aspirin (63.3%) followed by the calcium antagonists (61.7%) long acting nitrate derivatives (49.5%) and betablockers (41.5%). These results suggest that many post-infarction prescriptions disregard recently acquired scientific knowledge.

[New antimalarial sustained-release formulations based on bioresorbable polymers: therapeutic evaluation using the Plasmodium berghei model]

Chemotherapy keeps an important place in malaria control programme. The development of schizonticidal formulations, which may maintain their efficacy for at least one month after single administration, becomes needful. These formulations should allow to assure a suitable patient compliance and to avoid the disadvantages of high plasmatic peaks. The aim of this study is to evaluate the therapeutic efficacy of implantable bioresorbable reservoir-forms. The use of these polymers allow to avoid the surgical extraction of implanted preparations. Two drug delivery systems were prepared: microspheres and rods. Pyrimethamine, as a drug model was incorporated. Therapeutic activity of these preparations was evaluated on a TB mice-Plasmodium berghei model. Polycaprolactone and polylactide 100 microspheres are not suitable for long-term treatment. In contrast, implantable subdermic rods allowed to fulfil the long-term coverage requirements. Their activity depend on the administered dose and the drug content in implants. Polycaprolactone, polylactide 100 and polylactide 50 implants containing respectively 21.5%, 19-40% of pyrimethamine have protected animals for at least three months.

Sandostatin, a new analogue of somatostatin, reduces the metabolic changes induced by the nocturnal interruption of continuous subcutaneous insulin infusion in type 1 (insulin-dependent) diabetic patients

With the aim of assessing a new somatostatin analogue to prevent the metabolic changes induced by a 6-h nocturnal arrest of an insulin pump, nine C-peptide negative Type 1 (insulin-dependent) diabetic patients were submitted blindly to two interruptions (from 23.00 to 05.00 hours) of their continuous s.c. insulin infusion, once after a single s.c. injection at 23.00 hours of 50 micrograms SMS 201-995 (Sandostatin, Sandoz) and once after 0.9% NaCl. Plasma SMS 201-995 levels peaked at 24.00 hours and then declined with an elimination half-life averaging 144 +/- 15 min. Plasma glucagon and growth hormone levels were significantly reduced after SMS 201-995 whereas the progressive fall in plasma-free insulin levels from 23.00 to 05.00 hours was unaffected. In the control test, blood glucose levels tended to decrease slightly from 23.00 to 02.00 hours and then increased markedly from 02.00 to 05.00 hours (+5.3 +/- 1.5 mmol/l) while after SMS 201-995 they decreased significantly from 23.00 to 02.00 hours (-2.6 +/- 0.5 mmol/l), resulting in values below 3 mmol/l in seven subjects, but showed a secondary increase until 05.00 hours (+3.5 +/- 1.5 mmol vs 23.00 h; p less than 0.05 vs 0.9% NaCl). While the rises in plasma non-esterified fatty acid and glycerol levels were not reduced by SMS 201-995, the increase in plasma 3-hydroxbutyrate levels, although similar from 23.00 to 02.00 hours, was significantly reduced from 02.00 to 05.00 hours (+77 +/- 20 vs +124 +/- 31 mumols.l-1.h-1; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

alpha-Difluoromethylornithine induces protective immunity in mice inoculated with Plasmodium berghei sporozoites

Mice inoculated weekly with Plasmodium berghei sporozoites while under treatment with alpha-difluoromethylornithine (DFMO), an inhibitor of ornithine decarboxylase, developed protective immunity against subsequent challenge with this parasite. The percentage of mice protected was similar whether DFMO alone (55%) or DFMO + chloroquine (65%) was used. With chloroquine alone, only 12% of mice were protected. This protection was long-lasting (at least six months). The immunity protected against sporozoites but not against erythrocytic form inoculation. It is suggested that this protection is induced by antigens released from exoerythrocytic schizonts whose further development is inhibited by DFMO.

Development of new derivatives of primaquine by association with lysosomotropic carriers

On the basis of the drug-carrier concept of chemotherapy, we entrapped primaquine in liposomes, and linked it to an amino acid (leucine), and to peptides (alanyl-leucine and alanyl-leucyl-alanyl-leucyl) as intermediate steps in the synthesis of covalent primaquine-glycoprotein conjugates that would be selectively recognized by hepatocytes.The therapeutic activity of these compounds was tested in mice infected with sporozoites of Plasmodium berghei. Causal prophylatic cures were obtained after a single intravenous injection of primaquine-liposomes (60-70 mg of primaquine/kg of bodyweight) and lower doses (35 mg of primaquine/kg of bodyweight) of ala-leu-primaquine and ala-leu-ala-leu-primaquine.The administration of such high doses was only possible as a result of the decreased toxicity of primaquine when entrapped in liposomes and confirms the validity of the drug-carrier concept for the treatment of malarial infections. The improved chemotherapeutic index of ala-leu-primaquine and ala-leu-ala-leu-primaquine resulted from their decreased toxicity and increased chemotherapeutic activity. These peptide derivatives are probably acting as pro-drugs of primaquine.

[Hemineglect after right lesion. A report on three cases (author's transl)]

This paper is concerned with the observation of three cases of hemineglect after right frontal lesion. A review of cases indicates clear predominance of that semiology in subjects with right hemispheric damage. The observations are discussed with regards to facts and theoretical interpretations about the role of frontal areas in the determinism of hemineglect.

[Absence of signs of deconnection in four cases of partial anterior and median callosal lesions of vascular and neurosurgical origin (author's transl)]

Three cases of partial anterior and median callosal vascular lesions and one surgical case are presented. Some months later a neuropsychological examination did not show any signs of deconnection. Two interpretations are equally plausible: either the limited extension of the lesions as well as their location explain the absence of signs of deconnection, or these signs had existed but were regressive.

[Radiological appearances of hydatid cysts of the kidney. 10 confirmed cases (author's transl)]

Ten cases of hydatid cyst of the kidney are reported. The problem was invariably unilateral and isolated, involving the left kidney in 8 cases and the right kidney in 2 cases. IVP reveals a syndrome of a renal mass, sometimes enormous. Peri-cystic calcifications were visible in 7 cases, very localised in 5 cases and diffuse in 2. In 3 cases the kidney was non-functioning. No communication between the cyst and the excretory pathway could be seen at IVP in the two cases where it existed anatomically. Cystic parietography, partial or total, was visible in 4 cases. The mass was always avascular, without spur sign. The picture is very similar to that of a necrosed carcinoma of the kidney. Arteriography was not felt to be any more helpful than IVP in demonstrating the wall of the cyst. By contrast, changes in the trunk of the renal artery were common. The authors discuss the means avaliable for the radiological exploration of hydatic cysts of the kidney, in relation to the technical possibilities possessed in countries where the problem is endemic.

[An enormous gastro-intestinal hairball (author's transl)]

A case of a gastro-duodenal hairball is reported in a neurotic 19 year old woman. The case is remarkable because of the unusual length of the foreign body and the coexistence of two gastric ulcers which led to partial gastrectomy.

[Influence of spermatogenesis on testicular fluid secretion in adult rats]

Unilateral efferent duct ligature mainatined for 24 h in adult Wistar rats, shows that the secretion of testicular fluid elevates progressively with the age of animals (from 10 mg/g/h at a 100 days to 13 mg/g/h at a 150 days). This technique when applied to rats in which spermatogenesis is temporarily inhibited by busulphan shows, by contrast with control animals, a change in the secretion of testicular fluid which is the converse of the variation of spermatogenesis.

[Research on congenital Plasmodium berghei berghei malaria in mice. Transplacental passage of the parasite and its evolution]

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