Chikungunya outbreak in Reunion: epidemiology and surveillance, 2005 to early January 2006.
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Biomedical subjects
Publications and source records attributed to C Lassalle.
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The local Welfare and Health Authorities together with the country council of Reunion Island set up a medical supervision network for influenza and dengue fever in March 1996. Influenza of which the spreading over the island has never been well-researched is anticipated by a vaccination campaign organised in an empirical way after a model from the mother country (France). Dengue fever of which one of the vectors is omnipresent on the island ranged in an epidemic way in 1978. The aim of this network based on watching doctors, the laboratories of the island as well as the Pasteur Institute of Madagascar, is to adapt the prevention (Flu) and alert the Health Authorities in case of epidemic (Dengue). The article shows the results of 1996 observation and touches on the future of this type of supervision in a tropical environment.
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A patient is described who sustained the first reported colonic explosion during colonoscopic polypectomy. Mannitol solution was used for bowel preparation, and the colon was completely clean. During snare removal of a cecal polyp using high-frequency current a loud explosion occurred. In spite of emergency surgery with transfusion of 45 units of blood, uncontrollable hemorrhage persisted from multiple bleeding points, and the patient died. This occurrence seems to us to justify the routine use of carbon dioxide insufflation during polypectomy and the avoidance of mannitol for bowel preparation.
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Three cases of surgically treated para-duodenal hernia are presented. The literature is reviewed. Several modalities of this entity are described as well as the embryological hypotheses to explain their genesis. The diagnosis is usually made at the time of a laparotomy for bowel obstruction. The surgical manipulations to reduce the hernia content (one or several loops of small bowel) are discussed.