[Trust and conflicts in care, legal elements].

Trust is essential in all forms of medical care. It first appears when the patient chooses the professional, then when the latter suggests a treatment. This medical contract can be broken by both parties, if this trust disappears.

[Prognostic factors in operated non-small cell cancer of the lung. Study from a randomized therapeutic trial].

This article presents the results of a prognostic study of primary resected lung cancer (non-small cell). The data result from a randomised clinical trial of immunotherapy with a non-specific adjuvant; the follow-up was between four to seven years. Thirty-five clinical, biological and anatomo-pathological parameters were gathered at the time of inclusion in the trial.

Prognostic factors from a randomized clinical trial in resected lung cancer.

Prognostic information has three main uses: prediction of the course of evolution of disease, decisions about treatment and limitation of complementary tests. Using data from a randomized controlled clinical trial of immunotherapy in resected lung cancer, we identified factors of prognostic importance. In particular we demonstrated that a time-consuming and expensive cell-mediated immunity test is not of prognostic value.

[Therapeutic importance and tolerance of coated 50 mg Vectarion tablets (almitrine bismesylate) at a dosage of 100 mg/day. Study of blood gas, clinical and biological results after a year of long-term treatment].

The objectives of this study, in which Almitrine bismesylate was administered for one year in chronic bronchitics with obstructive hypoxia, were to assess its clinical and gasometric efficacy and its clinical, laboratory, spirometric and electrocardiac acceptability. The blood gas results show a significant rise in PaO2 (p less than 0.001) rising by 5.

Adjuvant immunotherapy with nonviable Mycobacterium smegmatis in resected primary lung carcinoma. A randomized clinical trial of 219 patients.

Two hundred and nineteen patients with resected lung carcinoma were randomized 3 weeks after surgery between two treatment arms: a control group (110 cases) and an immunotherapy group (109 cases). The immunostimulant was a nonviable saprophytic mycobacterium, M. smegmatis, given monthly by subcutaneous injection in four sites.

[Negative results of a randomized therapeutic trial of nonspecific immunotherapy in primary, surgically-treated non-small cell bronchial cancer].

Between March 1978 and May 1981, 219 patients suffering from non-small cell primary bronchial carcinoma underwent surgical excision which was intended to be curative. Three weeks later the patients were randomised into two groups: 1. A control group, with no other treatment following excision (110 patients).

[Long-term results of a trial of short-term chemotherapy. French study 6.9.12].

The relapse rate after short course chemotherapy is usually assessed by cases that are available for analysis, with a delay which rarely exceeds 3 years from the time of instituting therapy. This level may be disputed if too many are lost to follow up or non-compliers appearing late. To understand the true failure rate we strove to trace every patient in a trial carried out between 1969 and 1973, consisting of three groups of patients treated with the same chemotherapy: Isoniazid (450 mg/day), Rifampicin (600 mg/day) given every day but for differing durations: 6 months (Group A), 9 months (Group B), 12 months (Group C), with either daily Ethambutol or Streptomycin in addition for the first three months.

[Staged bronchial biopsies in the preoperative evaluation of primary bronchial cancer].

The systematic biopsying of the carina overlying a tumour, the main carina and of a contralateral carina was made a part of the work up in some patients with bronchial carcinoma, to assess operability. Different studies show that despite a normal macroscopic appearance these biopsies often reveal sub-mucous invasion. This microscopic extension might modify the resection planned, and even end in inoperability in the case of tracheal or contralateral tracheal invasion.

[Double paraneoplastic syndrome and anaplastic carcinoma of the lung. ADH and ACTH levels in the tumoral tissue (author's transl)].

A double paraneoplasic syndrome with hypersecretion of ADH and ACTH revealed the presence of a small cell bronchial cancer in a man aged 62 years. Water and electrolyte anomalies due to the hypersecretions were of such a degree that an occlusive syndrome occurred. Very high levels of ADH and ACTH were found in the tumoral tissue.

[A control trial of home I.P.P.B. therapy in patients with chronic obstructive respiratory insufficiency. Protocol and state of the study (author's transl)].

Because a previous retrospective study did not allow any conclusion as to the efficacy of home IPPB therapy in patients with chronic airflow obstruction, a control trial has been started. The protocol includes definition of patients, modalities of treatment, criteria for evaluation. Among criteria for a patient to enter the trial is a chronic hypercapnia (with PaCO2 greater than or equal to 48 mmHg) observed over a preliminary period of 4 months.

[The surgical treatment of thyrotoxic exophthalmos using Ogura's operation (author's transl)].

Ogura's operation consists of resection via De Lima's approach of the bony floor of the orbit and the lateral wall of the ethmoid. The orbital periosteum is then incised in order to allow the orbital fat to enter the sinuses and thus decompress the orbit. In most cases the operation is performed on both sides at the same time.

[Nasopharyngeal fibroma (author's transl)].

The authors report 17 cases nasopharyngeal fibroma treated between 1966 and 1978. Half of the cases developed before the age of 16, the other half occurring between 16 and 28 years. Arteriography was performed in only 8 cases and embolisation in 4 cases with 2 vascular accidents.

[Use of radiology in the diagnosis of posttraumatic otoliquorrhea. A report on 33 operated cases (author's transl)].

The association of standard radiography and tomography can enable the origin of the fistula to be established with reasonable precision : complementary contrast cisternography should permit direct localization. Treatment is essentially the concern of the E.N.