[Fast rhythms in metabolic diseases in children].

The authors study fast EEG rhythms in amino acidopathies of the newborn and in progressive encephalopathy of the central nervous system in children, when an inborn error of metabolism has either been found or is suspected. In the first group: amino acidopathies (including phenylketonuria), fast rhythms on the EEG of the neonates are of low amplitude, spindle-like bursts of 7-13 Hz and usually located in rolandic areas. This activity progressively disappears.

[Primary hyperaldosteronism: diagnostic value of the administration of a single dose of captopril].

The diagnosis of primary tumoral hyperaldosteronism is based on a series of hormonal parameters, measured under resting conditions and after stimulation. The results of the administration of a single dose of a converting enzyme inhibitor, Captopril (1 mg/kg body weight per os), can support this diagnosis. In contrast to essential hypertension and hyperaldosteronism due to bilateral adrenal hyperplasia, plasma aldosterone levels remain unchanged in tumoral hyperaldosteronism after administrating Captopril.

[A new diagnostic test for primary tumoral hyperaldosteronism].

Plasma aldosterone levels were measured during two tests of inhibition in 31 hypertensive patients (13 essential hypertension, 6 bilateral adrenal hyperplasia and 12 documented Conn adenomas) on normal salt diets after withdrawal of all therapy: 1--before and after intravenous infusion of 2 I normal saline in two hours; 2--before and three hours after administration of 1 mg/kg of Captopril. Plasma aldosterone levels greater than 360 pmol/I after salt loading, or greater than 748 pmol/I after Captopril is characteristic of primary tumoral hyperaldosteronism. Apart from the rapidity of the test, Captopril is well-tolerated, does not require acute volume expansion and can be carried out in all forms of hypertension, even in severe cases.

[Antinuclear antibodies and lupus induced during treatment of arterial hypertension. Role of beta-blockers and alpha-methyldopa].

Comparison of hypertensive patients receiving no treatment with subjects of the same age reveals the presence of antinuclear antibodies in twice as many of the former as the latter. Various antihypertensive drugs increase this prevalence. They may induce iatrogenic lupus.

[Electroencephalographic aspects and thiopental in 4 cases of severe pneumococcal meningitis in children].

We present an electroclinical study of 4 severe pneumococcal meningitis cases with intracranial hypertension. In addition to classical anticerebral edema therapy thiopental infusion was used. The plasma thiopental level seems to be only an incomplete indicator of cerebral drug effect, but must be measured to avoid accumulation.

Simultaneous measurement of beta-endorphin, lipotrophins and met-enkephalin in phaeochromocytomas.

Tissue concentrations of immunoreactive lipotrophin, beta-endorphin, and met-enkephalin were determined in 10 phaeochromocytomas, 3 of which were responsible for the ectopic ACTH syndrome. Lipotrophin and beta-endorphin immunoreactivities could be detected in all cases, whether or not Cushing's syndrome was present, and their tissue concentrations were significantly correlated (r = 0.95, P less than 0.

[Incidence and fetal impact of hypertension in pregnancy: study of 2996 pregnancies].

To evaluate the incidence and the foetal effects of gestational hypertension, we studied 2 996 pregnancies with a single live birth in mothers selected on the basis of 1) a documented diastolic blood pressure (DBP) less than 90 mmHg before the 16th week of amenorrhea and 2) no history of hypertension or kidney disease. In 38,4% of the gravidas, the highest DBP during pregnancy was greater than or equal to 90 mmHg, and in 15,4% this level was reached twice or more. Gestational hypertension (two DBP readings greater than or equal to 90 mmHg) was more frequent in nullipara than in mothers with previous pregnancies (17,9 versus 12,4%, p less than 0,01) and its incidence tended to decrease with increasing maternal age.

[Critical evaluation of the functional signs of arterial hypertension].

Influence of blood pressure levels on the prevalence of symptoms was studied in a group of 1771 untreated hypertensive patients referred to the Saint-Joseph Hypertension Clinic in Paris. Information on symptoms was obtained from a standardized physician-conducted interview during the patient's first visit at the Outpatient Clinic. The most frequent symptoms were headaches (40.

[Kidneys; hypertension and pregnancy. III. The renal risk in pregnancy].

When a woman with chronic renal disease wishes to become pregnant, the risk to the mother and the foetus is often inaccurately evaluated or exaggerated. In patients with primary nephropathy the foetal risk is significantly increased by the arterial hypertension frequently associated with renal insufficiency. In systemic lupus erythematosus (SLE) with renal involvement, the risk represented by hypertension is compounded by a high incidence of spontaneous abortion, particularly when the disease is progressive.

[Kidneys, hypertension and pregnancy. II. Hypertension in pregnancy: significance, prognosis, and treatment (author's transl)].

A rise in arterial pressure above 140 mmHg systolic or 85 mmHg diastolic is pathological in pregnant women. Such changes may either reveal chronic hypertension or constitute a purely gestational complication. The persistence or regression of abnormally high BP values 3 months after delivery retrospectively indicates whether the hypertension was chronic or pregnancy-related.

Sleep apneas in normal neonates and infants during the first 3 months of life.

Sleep polygraphic recording was carried out on 52 normal full-term babies. 16 infants were recorded at 2 - 7 days of age, 14 at 2 to 5 weeks, 13 at 6 to 9 weeks and 9 at 10 - 13 weeks. Central apneas of 2 sec and over were analysed in Active Sleep (AS), Quiet Sleep (QS) and Transitional Sleep (TS).

[Kidneys, hypertension and pregnancy. I. Renal function in normal pregnancy (author's transl)].

Pregnancy enhances renal functioning. As early as the first week of amenorrhoea, renal plasma flow (RPF) and glomerular filtration rate (GFR) increase by 30 to 50%, with parallel rise in creatinine and urea clearances. The water and salt balance becomes strongly positive.

Respiratory pauses in normal infants and in siblings of victims of the sudden infant death syndrome.

Sleep polygraphic recording was carried out on 57 normal infants and on 100 SIDS siblings during morning naps between birth and the 4th month of life. Total sleep time and duration of sleep stages were determined. Central apnoeas of 2 sec and longer duration were analysed in AS, QS and IS.

[Neonatal status epilepticus of unknown etiology (author's transl)].

Forty-three neonates with status epilepticus of unidentified etiology were studied by EEG. 90% had favorable outcome. In the cases with unfavorable evolution the following criteria allowed an early poor prognosis: a very early onset of the seizures in the first or second day of life, the presence of tonic seizures and hypertony between seizures, duration of the seizures more than 4 days, EEG activity in the frequency of the alpha band during the seizures, a flat tracing after the seizures, very discontinuous activity between the seizures and, finally, the reappearance of seizures after a seizure-free interval.

[Convulsive seizures in the neonatal metabolic diseases (author's transl)].

Of 61 newborns with disorders in amino acid metabolism, 20 had seizures; 15 of them have been recorded. Clinically, seizures are mostly partial clonic jerks. There seems to be some homogeneity of EEG features in relation to causal amino acidopathy.

[Acquired aphasia in epileptic children--four cases with electrical infraclinic status epilepticus during sleep (author's transl)].

Four cases of acquired aphasia in epileptic children, associated with sub-continuous bitemporal paroxysmal activities (PA) during sleep, are described. Clinical improvement always followed the decrease or the unilateralization of PA. Persistence or aggravation of aphasia was observed when PA again became bitemporal and sub-continuous.