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The passage to ambulatory care of a patient with a long hospital stay due to a wrenching disease is not something obvious. The doctor and the care staff will have to take up the challenge of dealing with an important amount of care. The quality of life of the patient and his caregivers is influenced by the neuropsychiatric disorders, the illness intrusiveness and the depression that come along with them. The chronic disease intruding causes a crisis in their lives. In order to better evaluate these factors we are using the Illness Intrusiveness Rating Scale developed by Devins. This article addresses the high complexity of clinical situations handled in an environment of rehabilitation care with the support of the consultants, nurses and doctors, of the liaison psychiatry.

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During the fall of 2003, mild mosaic symptoms were observed in melon (Cucumis melo L.) plants grown in glasshouses near Eyragues (southeastern France) resembling those caused by the Bemisia tabaci transmitted Cucumber vein yellowing virus (CVYV, genus Ipomovirus, family Potyviridae). In addition, large numbers of B. tabaci were observed to be colonizing these crops. The identification of CVYV was established through differential host range reaction, immunosorbent electron microscopy (IEM), and reverse transcription (RT)-PCR experiments. Crude sap from symptomatic leaves was used to inoculate differential host plants. Mild mosaic symptoms were observed on melon, and cucumber developed vein-clearing symptoms typical of CVYV. No symptoms were observed in Chenopodium quinoa, C. amaranticolor, Nicotiana benthamiana, N. tabacum, and Vigna sinensis. Numerous, slightly flexuous, elongated virus particles were observed in infected plant extracts; these particles were decorated by a polyclonal antiserum raised against a Sudanese CVYV isolate. To confirm CVYV identification, total RNA extracts (TRI-Reagent, Sigma Chemical, St. Louis, MO) were obtained from the original symptomatic melon tissues. RT-PCR was carried out using CVYV-specific primers CVYV-CP-5': 5'-GCTTCTGGTTCTCAAGTGGA-3' and CVYV-CP- 3': 5'-GATGCATCAGTTGTCAGATG-3' designed according to the partial sequence of the coat protein gene of CVYV-Isr (GenBank Accession No. AF233429) (2). A 540-bp fragment corresponding to the central region of CVYV coat protein was amplified from total RNA extracted from symptomatic but not from asymptomatic melon tissue. Direct sequencing was done on RT-PCR products (GenBank Accession No. EF441272). The sequence was 95 and 99% identical to that reported for CVYV isolates from Israel and Spain, respectively. CVYV was first described in Israel and has recently emerged as the cause of important diseases in Spain and Portugal (1,3). Shortly after detecting CVYV during 2003, efforts were made to eradicate the virus in susceptible crops. CVYV was not detected again during intensive surveys conducted in southeastern France during 2004, 2005, and 2006, suggesting that the CVYV detected during 2003 resulted from an accidental introduction and that the virus has not become established in France. References: (1) I. M. Cuadrado et al. Plant Dis. 85:336, 2001. (2) H. Lecoq et al. J. Gen. Virol. 81:2289, 2000. (3) D. Louro et al. Plant Pathol. 53:241, 2004.

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In summer 2000, symptoms similar to Pelargonium zonate spot virus (PZSV) were observed for the first time on tomato plants in southeastern France. The plants were from commercial glasshouse fresh-market crops. Symptoms observed were chlorotic mottling with bright yellow distinct rings on leaves and curved line patterns on stems. Fruit symptoms included chlorotic and necrotic spotting, marked concentric ring patterns, and distortions. Diagnosis was made from symptomatic leaves and fruits by mechanical inoculation on a set of host plants. Local chlorotic and necrotic lesions were observed on Chenopodium amaranticolor, C. quinoa, Cucumis sativus cv. Marketer, Cucumis melo cv. Vedrantais, Phaseolus vulgaris cv. Pinto, Vicia faba cv. D'Aguadulce, Vigna unguiculata cv. Black Eye, and systemic symptoms were observed on Capsicum annuum cvs. Yolo Wonder, Yolo Y, Florida VR2, and Criollo de Morelos 334, Datura stramonium, Lycopersicon esculentum cvs. Momor and Stevens, L. hirsutum (PI 134417 and PI 247087), Nicotiana benthamiana, N. clevelandii, N. tabacum cv. Xanthi nc, Ocimum basilicum cv. Latino, Petunia hybrida cv. Rose du ciel, and Physalis floridana. No reaction was observed on Pisum sativum cv. Douce Provence, Salvia splendens cv. Etna, or Zinnia elegans cv. Liliput. Symptoms on tomato of PZSV, Parietaria mottle virus (PMoV), and Tomato spotted wilt virus (TSWV) are similar, particularly those elicited in fruits. Therefore, the field samples were checked using double-antibody sandwich enzyme-linked immunosorbent assay against antisera of the type-strain of PZSV and tomato strain of PMoV and their homologous antigenes, which were supplied by D. Gallitelli and P. Roggero respectively, and our antiserum of TSWV. Electron microscopy of negatively stained preparations from leaves of tomato and D. stramonium showed that the sap contained very few paraspheric shaped particles, 26 to 29 nm in diameter. Three isolates collected from two different regions (Vaucluse and Bouches du Rhône) showed a very close serological relationship with the Italian type-strain of PZSV and tested negative against antisera of PMoV and TSWV. The French isolates were biologically different from the type-strain, but were similar to the Spanish strain of PZSV because they infected D. stramonium, N. benthamiana, O. basilicum, and V. unguiculata (2). Moreover, in transverse tissue sections, virions were not observed in the nucleus and tubular structures, unlike the Italian isolates, (1) but were present in the cytoplasm and particularly in the mesophyll cells. There are only a few records of the occurrence and distribution of PZSV in Mediterranean countries. References: (1) M. A Castellano and G. P Martelli. Phytopathol. Mediterr. 20:64, 1981. (2) M. Luis-Arteaga. Plant Dis. 84:807, 2000.

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The chronic anterior compartment syndrome of the forearm is a rare pathology (3 cases have been already published), and of new knowledge. Three new cases on 2 patients (one on both sides) are described here. The authors describe recent advances about physiopathology, exploration and surgical treatment. It is due to strenuous activity using flexor muscles of the forearm without any release period (here motor cyclist competition). The symptom was pain at the anterior forearm similar to cramp. The most important for diagnosis was to measure the pressure after activity. The threshold level read after activity was up to 30 mm of Hg, with a very slow coming back to normal value. The isotopic scanner with hydroxyl methylene di-phosphonate (HMDP), after activity, showed a delay of arrival of the tracer and a stasis. RMI seems to give abnormal modification of the signal. The only treatment was surgical and an open fasciotomy of superficial and deep fascia must be done, with opening of the muscle's perimysium. The patients became painfree and resumed their sport after surgical treatment.

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Functional treatment of humeral shaft recent fractures by A. Sarmiento's method was described in 1977. It is based on fixation with a plaster or plastic sleeve individually molded. This sleeve keeps free the adjacent joints, allowing an early functional rehabilitation and a fast consolidation. A 50 cases serial study from 1983 to 1987, confirms the advantages of a method which allies reasonable means, safety and complete reliability to obtain a good and rapid consolidation (one case of non-union due to a technical failure), and rapidly recovered function. We had frequently resulting axial defects: 16 patients have mal-union with more than 10 degrees of angular deformity but without any functional consequences. The advantage of this method compared to usual orthopaedic, or surgical treatments leads us to propose it to most of our patients.

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Bile acid loss (mg/m2 24h) in the stools of 43 cystic fibrosis (CF) children with pancreatic insufficiency was 751-1 +/- 48-3, while that of six without clinical evidence of pancreatic disease (133-4 +/- 15-9) did not differ from values in 25 controls (109-8 +/- 9-8). There was a good correlation between the degree of bile acid (BA) and fat sequestration. Concomitant changes in bile acid and fat loss were observed in the one group of six patients studied on and off pancreatic enzymes as well as in a second group of seven children treated with pancreatic supplements and maintained on a normal diet followed by a low fat diet supplemented with medium chain triglycerides. Administration of NA bicarbonate led to a significant decrease in fat loss (15-8 +/- 2-7 leads to 10-3 +/- 1-9) without any simultaneous change in bile acid excretion (533-1 +/- 58-3 leads to 500-4 +/- 58-6). Qualitative bile acid patterns in controls, in infants after an ileal resection, and in patients with CF or with coeliac disease showed that the percentage of primary BA followed closely the total amount excreted except in situations where antibiotics were administered. The exact mechanism for the increased loss of BA in CF is unknown. It is found in all age groups and is related to the presence and degree of pancreatic insufficiency. The possibility that unhydrolysed triglycerides may interfere with the intestinal absorption of bile acid needs further confirmation.

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