Half of thrombocytopenic purpuras occurs after a viral infection and is cured in a few weeks, but 10% of the cases are chronic. Toxic purpura is exceptional. Most of the cases are idiopathic. At the beginning it is impossible to foresee acute or chronic evolution. No treatment is necessary in ITP without serious bleeding. Prednisone does not avoid chronic state but shortened duration of acute ITP. Dosage is 1 mg/kg/day. Continuous corticotherapy is excluded in chronic ITP. Short corticotherapy is useful during bleeding periods. Splenectomy is to be considered after 6 or 12 months. Overall success raise 75%. Splenectomy is forbidden temporarily before 5 years, and definitely in immune deficiency. Immunosuppressive drugs are rarely used in childhood. Treatment with infusion of vincristine labeled platelets is in study. During the 18 months after cure, vaccinations must be avoided.

Child↗

PubMedDate not supplied

[Rectal adenocarcinoma in adults under 35 years of age. Apropos of 37 cases].

Minimum follow up of 37 cases treated at the "Institut Gustave-Roussy (IGR)" over the last 10 years has been for more than 23 months. Twenty-three of these patients had been treated entirely by the IGR using surgery and radiotherapy (45 to 60 Gy). Excision was curative in 13 cases and palliative in 10. Several conclusions can be drawn: The relative frequency in inhabitants of mediterranean countries (particularly North Africa and Italy where this cancer is respectively 15 ans 17 times more frequent than in young Frenchmen) and in women; the absence of obvious predisposing factors; the frequency of mucosal colloid forms (57%), and the extent of the lesion at diagnosis (60%, of Dukes C2 and 20% of Dukes D) even when there was no delay between first symptoms and diagnosis; and the 2-year survival (45%) in the patients treated in the IGR alone, whereas it is 75% for the 285 patients over 35 years of age. Early diagnosis, including in young adults, is essential, as well as immediate radical surgery and radiotherapy.

Adenocarcinoma↗

PubMedDate not supplied

[Urethral stricture: single-stage urethroplasty by a free skin flap].

A single-stage procedure involving the use of a free skin flap for the correction of urethral strictures was performed on eighteen patients. In this series, the strictures were mainly located in the region of the bulbar urethra. Good results were obtained in fourteen cases (80 per cent) out of the eighteen, with a two year followup, or less. The method is simple and effective. In the authors' experience, it has provided a higher success rate than any other procedure described to date. In view of this high success rate, and the equivalent successes reported in the literature, the authors consider that this technique, and urethrotomy, constitute the treatment of choice for urethral stenosis.

Adult↗