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Biomedical subjects

M Chapuis

Publications and source records attributed to M Chapuis.

16 recordsLinked to original sources

[Posttraumatic nonunion of the clavicle in a child: case report].

A thirteen-year-old child underwent surgery for posttraumatic nonunion of the clavicle. This complication, which is uncommon in adults and exceptional in children, occurred after three fractures of the left clavicle. The diagnosis can be retained after ruling out congenital nonunion of the clavicle. Surgery can be proposed if functional impairment persists for at least one year. For children, the preferred technique is osteosynthesis with centromedullary pinning and bone graft. While surveillance may not be necessary for a unique fracture of the clavicle, prolonged surveillance appears to be necessary in patients who sustain repeated fractures of the clavicle.

Child, Preschool↗

[Stiff painful spine in an 11-year-old girl with SAPHO syndrome].

Compression of the cervical spinal cord developed six months after the first signs of a stiff and painful spine in an 11-year-old girl. The clinical course, the association with other skeletal localization, particularly the sacroiliac joint and the roof of the acetabulum and the pathology findings of nonspecific inflammation led to the diagnosis of chronic recurrent multifocal osteomyelitis that can be included in a SAPHO syndrome (synovitis-acne-pustulosis- hyperostosis-osteitis). We report the specific findings in our case and review the literature to define the nosology framework of this rather uncommon condition. To our knowledge, this is the first report of spinal cord injury in a child related to SAPHO syndrome.

Acquired Hyperostosis Syndrome↗

Testing kin selection with sex allocation data in eusocial hymenoptera

Sex allocation data in eusocial Hymenoptera (ants, bees and wasps) provide an excellent opportunity to assess the effectiveness of kin selection, because queens and workers differ in their relatedness to females and males. The first studies on sex allocation in eusocial Hymenoptera compared population sex investment ratios across species. Female-biased investment in monogyne (= with single-queen colonies) populations of ants suggested that workers manipulate sex allocation according to their higher relatedness to females than males (relatedness asymmetry). However, several factors may confound these comparisons across species. First, variation in relatedness asymmetry is typically associated with major changes in breeding system and life history that may also affect sex allocation. Secondly, the relative cost of females and males is difficult to estimate across sexually dimorphic taxa, such as ants. Thirdly, each species in the comparison may not represent an independent data point, because of phylogenetic relationships among species. Recently, stronger evidence that workers control sex allocation has been provided by intraspecific studies of sex ratio variation across colonies. In several species of eusocial Hymenoptera, colonies with high relatedness asymmetry produced mostly females, in contrast to colonies with low relatedness asymmetry which produced mostly males. Additional signs of worker control were found by investigating proximate mechanisms of sex ratio manipulation in ants and wasps. However, worker control is not always effective, and further manipulative experiments will be needed to disentangle the multiple evolutionary factors and processes affecting sex allocation in eusocial Hymenoptera.

Journal Article↗

[Severe streptococcal group A infection complicating varicella].

UNLABELLED: Varicella is a common viral infection which is generally benign in infancy and has a good outcome. It may sometimes be complicated by severe group A streptococcal superinfection. CASE REPORT: Three days after the beginning of varicella, a previously healthy 2-year-old girl presented with left leg pain, lameness and edema of all four limbs. Toxic shock syndrome occurred, due to beta-hemolytic group A Streptococcus grown from blood culture. Computerized tomography (CT) scan showed a mild effusion involving both hips. Cefotaxim was administered, but the week after magnetic resonance imaging (MRI) showed a necrotizing fasciitis and a lesion of the left leg leading to a patchy femoral diaphysis consistent with osteomyelitis. Joint aspirate culture did not grow. The left leg was immobilized in plaster for 6 weeks and the child was given cefotaxim and fosfomycin parenterally during 30 days, then followed by 45 days of oral amoxicillin. She recovered without sequelae. CONCLUSION: Group A Streptococcus infection is a dangerous complication of varicella. It must be considered in case of any joint pain occurring during or just after this disease. The choice of the best treatment needs full collaboration between surgeons, radiologists and pediatricians.

Cefotaxime↗

[Percutaneous in situ pin fixation in superior femoral epiphysiolysis].

PURPOSE: The purpose of this study was double. We evaluated long term results in 30 patients who had in situ pinning fixation. We tried to assess the advantage of pinning versus screw fixation. MATERIAL AND METHODS: We reviewed retrospectively 30 cases treated for SCFE by in situ pinning fixation. Between august 1985 and may 1995, 33 hips were treated (3 bilateral cases). The age averaged 10 years and 3 months. Twenty-one cases were chronic (64 per cent), 8 cases were acute forms (21 per cent) and 4 acute cases revealed progressive cases (14 per cent). There were 19 boys and 11 girls. The osteosynthesis was made with 3 pins (except in 4 cases with only 2 pins). RESULTS: The follow-up ranged from 20 to 50 months (average 35 months). The upper femoral growth plate was closed at an average of 16 months after surgery (6 months to 21 months). Three prophylactic controlateral fixations were performed before our protocola was established. No pin penetration was noted. No chondrolysis or avascular necrosis was noted. Complications were: 2 superficial hematomas with spontaneous resorption, 1 lateral pin migration without consequence on fixation, 1 break-pin in soft tissue without clinical consequence. The main complication was, in one case, a secondary slipping of the epiphysis after premature pin removal. Hip function was normal except in 2 cases with loss of motion in internal rotation. DISCUSSION: Stiffness of the screw is the most important advantage. A single screw seems to be enough. Removal of the screw is difficult, sometimes impossible. CONCLUSION: Percutaneous in situ pinning in SCFE is recommended. It is an easy surgical technique with an absence of complication such as chondrolysis or avascular necrosis in our experience. It is also the easiest method for hardware removal.

Acute Disease↗

Late presenting Bochdalek hernia containing colon: misdiagnosis risk.

The case of an eleven-months-old girl is reported: she entered the intensive care unit for fever, vomiting and left pleural effusion. Abdominal echography, CT scan and colonic opacification led to the diagnosis of a colonic Bochdalek hernia. A review of the literature showed that colonic hernias are rare, with only five previous reported cases in which colon was found in the thorax. The authors emphasise that there is a high risk of misdiagnosis due to the fact that small intestine contrast studies are normal; only colonic contrasting may lead to the right diagnosis. The roles of echography and CT scan are discussed.

Colon↗

A case of Larsen syndrome with severe cervical malformations.

The authors report Larsen Syndrome in a male newborn with severe cervical spine malformations: segmentation abnormalities of the cervical spine and atlanto-axial dislocation. The severity of the cervical malformations occurring more often in the autosomal recessive form is emphasized.

Abnormalities, Multiple↗

[Duplication of the urethra in a young girl. Apropos of a case].

Duplication of the female urethra is quite uncommon. A case of complete urethral duplication is reported in a 2.5 year old girl seen for pyuria. Physical examination showed and epispadiac meatus with dribbling urine just above a bifid clitoris associated with an orthotopic meatus. The two urethras were patent and situated on the same sagittal plane as seen on the cystography. The treatment consisted of excising the whole epispadic urethra using a combined perineal and suprapubic approach enlarged by symphyseal section for a better repair of the bladder outlet. Postoperatively, the patient was content and free of symptom. The main features of urethral duplication in girl are reviewed.

Child, Preschool↗

[Millard's flap for sequelae of high anorectal malformations. Apropos of 6 cases].

Mucosal prolapse is a frequent sequela after surgical treatment of the high type of anorectal malformation whatever was the technic used for the pull-through operation. The authors report six cases treated with the spiral flap described by Millard. The initial procedures had been a Romualdi-Rehbein pull through in three cases with secondary revision of anoplasty and a Stephan's operation in the three other cases. Before Millard's plasty, all the patients were continent and two of them had an associated stricture. The anatomical result was good in all the cases with reconstruction of a cutaneous anal funnel and no stricture. Improvement of continence was noted in two cases, uncertain in two. Incontinence remained unchanged in two other cases. The advantages of the Millard's plasty are analysed. The prevention of mucosal prolapse is possible in the initial pull through operation using the same plasty or whatever plasty which provides a cutaneous anal canal.

Anal Canal↗

[The multiseptate gallbladder. A rare malformation of the biliary tract].

Multi-septate gallbladder is a very rare anomaly. In this 13-years-old girl with a complaint of nausea, vomiting and abdominal pain, sonographic examination and oral cholecystogram demonstrated a normal size gallbladder with many thin septa. The longitudinal section of the removed gallbladder revealed multiple inter-communicating lobules divided by many thin septa. She has been free of the previous complaints after surgery. Only two pediatric cases have been reported previously. Our case illustrates the main features of this entity.

Adolescent↗

[Primary obstructive megaureter in infants: medical or surgical treatment? Apropos of 24 cases].

The authors analyse 24 cases of primary obstructive megaureter diagnosed before the age of 3 months. 18 were discovered by antenatal echography between 28 and 39 weeks, whereas 6 were detected by the occurrence of early urinary tract infection. Initial investigations included echography, intravenous urography and micturating cystouretrogram. Primary megaureter was bilateral in 14 cases, unilateral in 12. According to the urographic classification of Beurton, there were 12 ureters stage III, 12 stage II, 10 stage I. 15 patients were operated, 4 of them during the first months (2 reimplantations, 2 urinary diversions). 12 were submitted to later reimplantation at the mean age of 15 months, one had a non functioning kidney removed. 9 were non operated and treated conservatively by antibacterials and regular supervision. Results analysis evaluated according to radiological stage and treatment showed that in more cases, surgery should be differed initially. Complete clinical and radiological resolution is possible even in severe obstructions. Antibacterial treatment beginning at birth favorises regression of dilated ureter. Thus reimplantation should be deferred undercover of regular biological and radiological survey. The age of 12 to 18 months is the most technically favorable time to ureteric reimplantation.

Female↗

[Orbital and muscular relapse of Burkitt's lymphoma].

We report the case of a child presenting with abdominal Burkitt's lymphoma in whom a relapse presented as orbital and muscle involvement. This clinical feature is extremely rare. Two muscle and one orbital biopsies were necessary to obtain proper diagnosis. A new extension check-up showed bone marrow invasion and normal cerebrospinal fluid. This relapse was successfully treated by conventional chemotherapy and consolidated with high-dose chemotherapy, total body irradiation and autologous bone marrow transplantation. Eighteen months after transplantation, the child may be considered as definitively cured.

Bone Marrow Transplantation↗

[The value of MRI in popliteal entrapment syndrome].

The popliteal artery entrapment syndrome (PAES) is a frequent disease of especially young patients, often following a muscular exertion. To avoid the complications, the diagnosis must rapidly be done. According to this report of a 12 year old child, we think that magnetic resonance imaging (MRI) is very accurate to diagnose the abnormalities of the popliteal artery course, the muscular hypertrophies and can relieve of more invasive procedures such as the arteriography associated with known morbidity in young patients.

Child↗