[Sneddon syndrome with anti-mitochondrial type M5 antibodies].

Introduction: Antimitochondrial type M5 antibodies (AMA-M5) are among the immunological abnormalities associated with Sneddon syndrome.

Case: A 45 year-old woman, hospitalized for diplopia and with a 20-year history of obstetrical accidents, internuclear ophthalmoplegia and livedo, was diagnosed with Sneddon syndrome associated with primary antiphospholipid syndrome (APS) aggravated by the presence of AMA-M5.

Discussion: AMA-M5 are immunological markers of APS to the same extent as antiphospholipid antibodies.

[Digital ischaemia and gemcitabine. Two new cases].

Chemotherapy generates numerous adverse effects, but digital ischemia is usually associated with a paraneoplastic mechanism. In addition to thrombotic microangiopathy or hepatic or pulmonary venoocclusive disease gemcitabine appears to induce this type of complication. This study presents two cases of digital ischemia, which are very likely attributable to gemcitabine.

[Chronic meningitis: aetiologies, diagnosis and treatment].

Purpose: Chronic meningitis are very uncommon and account for less than 10% of all meningitis cases. Their symptoms are uncunth and there outcome is insidious. Therefore, they remain often unknown.

High prevalence of hepatitis C virus RNA in the supernatant and the cryoprecipitate of patients with essential and secondary type II mixed cryoglobulinemia.

Detection of hepatitis C virus RNA by polymerase chain reaction was performed in 26 patients with type II mixed cryoglobulinemia, and compared with anti-HCV antibody detection. The patients were divided into two groups according to etiology: 15 had essential type II mixed cryoglobulinemia and 11 had secondary type II mixed cryoglobulinemia. In the essential type II mixed cryoglobulinemia group, the prevalence of hepatitis C virus RNA detected by polymerase chain reaction was 60% in the supernatant and 93% in the cryoprecipitate.

[Does the blood pressure balance obtained in hospitalized hypertensive patients remain satisfactory a month later at home? (Ambulatory measurement)].

Twenty patients with hypertensive heart disease have been hospitalised for adjustment of their antihypertensive medication. The new treatment was left unchanged during a period of forty days, the survey consisted in three blood pressure measurements at rest every day during the first ten days of hospitalisation and an ambulatory blood pressure measurement the 10th and 40th day. The 10th day, there is no significant correlation between blood pressures measured at rest and ambulatory, even if the average BP levels are not significantly different.

[Evaluation of the importance of ambulatory blood pressure measurement in the diagnostic and therapeutic management of hypertension].

Purpose: evaluate, in a Public Health approach, the contribution of ambulatory blood pressure recordings (ABPR) in the diagnostic and therapeutic management of hypertension.

Methods: a retrospective study is led among 32 physicians who have addressed 473 patients for ABP: 182 for borderline hypertension (B-H) diagnosis, 94 for treatment decision (NT-H) and 197 for a therapy efficiency assessment (T-H). ABPR is performed with the non invasive Spacelabs device on a 24 hour period.

Chronic trichloroethylene intoxication: a new approach by trigeminal-evoked potentials?

Trigeminal nerve impairment is frequently seen in chronic trichlorethylene intoxication (TRI). A total of 104 occupationally exposed subjects were selected for study because they were employed at a highly exposed workplace. They were studied by clinical examination and by trigeminal somatosensory evoked potentials (TSEP).

Determination of beta-endorphin in alcoholic patients in the acute stage of intoxication: relation with naloxone therapy.

beta-Endorphin was measured in the plasma of control subjects and 12 chronic alcoholics in the acute stage of ethanol intoxication. Naloxone was administered and the level of beta-endorphin was compared before and after treatment. The increased level of beta-endorphin in the intoxicated subjects supports the presence of ethanol interactions with the opioid system, since pituitary secretion does not seem to be involved.

[Can ambulatory blood pressure be assessed using 9 self-measurements?].

This study compares the blood pressure (BP) levels, the variability and the circadian BP variation recorded in ambulatory (AM) and self measurement (SM) conditions. The BP is recorded every 15 min on the day time with an automatic device (Space-labs) in a population of 16 normotensive patients; the same day, each patient performs with an half automatic device (SEB) 9 self measurements between 8 am and 8 pm. The SM method provides significantly lower mean values: -3.

Comparative study of the efficacy of captopril at a single daily dose of 100 mg and at a twice daily dose of 50 mg by measuring ambulatory pressure over 24 hours.

Variations in blood pressure were investigated by an automatic, non-invasive ambulatory method in 9 subjects with essential hypertension. Recordings were made after 6 week periods during which captopril was taken either once or twice daily, in a double-blind cross-over study. Although the effects of captopril administration either once or twice daily were broadly similar, there was a significant decrease in diastolic blood pressure values on the once-daily regimen.

[Personality characteristics of hypertensive patients. Study of subjects with essential hypertension compared to a control population].

Starting from projective situations--thematic apperception test (TAT) we have researched personality characteristics liable to be found in hypertensive subjects. With reference to a control group of 59 subjects we have studied 41 essential hypertensive subjects. They undergo a preliminary interview structured on the questionnaire type, are classically tested with the TAT, have one or several free interviews.

[Ambulatory measurement of arterial pressure. Diagnostic, prognostic and therapeutic value].

The invasive and non-invasive techniques now available for automatic monitoring of blood pressure have provided new sets of physiological as well as diagnostic and therapeutic data. Recordings of blood pressure variations over a 24-hour period have shown that it increases during the day and decreases at night, that these physiological changes are more pronounced in the elderly than in young subjects and also that they depend on the degree of physical activity. The clinical applications of these techniques rest on the possibility of recording a blood pressure-activity profile over time, in order to speak, ultimately, in terms of blood pressure load activity.

[Data on the echocardiogram, pressure profile during exertion, and ambulatory blood pressure measurements in borderline arterial hypertension].

Comparative study is performed between echocardiographic measurements (TM), exercise test blood pressure profile (ETP) and ambulatory blood pressure load (BPL) in 26 borderline hypertensive subjects (19 males, 7 females). An abnormal ETP is found for 15 subjects (57 p. 100), an abnormal BPL for 10 subjects (38 p.

[Changes in sweating during exertion. Effects of beta-blocker treatment].

Eccrine sweat secretion is studied during physical stress after the administration of a B-blocking agent: Butofilolol. 20 voluntary normotensive subjects, age 24 + 2 ans are submitted to 2 exercises stress test (ergometric bicycle) performed at on week interval. Butofilolol is administrated at a posology of 200 mg, 24 hours and 2 hours, before the test as well as placebo (double blind).

Trichloroethylene occupational exposure: elements for better prevention.

One hundred and eighty-eight workers occupationally exposed to trichloroethylene (TRI) were studied by physical examination, exposure parameters (measure of atmospheric TRI and urinary trichloroacetic acid (CA) and evaluation of personal factors (age, alcoholic and tobacco consumption). A statistical comparison (chi 2 test) of the frequency of the symptoms observed in the high- and low-exposure populations with an analysis of nonprofessional factors allowed us to distinguish different classes of symptoms. Those more likely linked with TRI exposure are trigeminal and optic nerve impairment, asthenia, headache and dizziness.

Internuclear ophthalmoplegia in patients with toxic coma frequency, prognostic value, diagnostic significance.

Internuclear Ophthalmoplegia (INO), a dysfunction of the medial longitudinal fasciculus, is frequently seen in toxic coma (7 out of 70 cases). INO is most often bilateral and can be associated with different stages of coma. Such an association is a strong argument for the toxic etiology of a coma.

[Ambulatory measurement of arterial pressure by a noninvasive procedure. Study of its variability in 18 normotensive subjects and 25 hypertensive patients. Research on criteria of normality].

Ambulatory blood pressure monitoring by an automatic non-invasive procedure allows the measurement of a large number of blood pressures and provides information in the variations of blood pressure during normal activity. The development of a programme on a minicomputer has helped simplify the expression of the results by: --a graphical representation of the evaluation of the blood pressure with respect to time (chronogramme); --a histogramme showing the distribution of the blood pressure values; --a representation of the pressure load with respect to time. By stocking the individual results a statistical study could be undertaken of the whole population.