Effect of physicians opinion on patients' choice of treatment.

Background: While it is obvious that patients should be involved in the decision making process, questions arise as to whether it is feasible to inform them objectively.

Objective: To assess the impact of the physician's opinion, on the choice of treatment, to the patient.

Setting: We imagined a hypothetical case of a 55-years-old woman with a high risk of osteoporosis.

Health perception by women who work in a medical environment.

A mail survey was sent to 1154 women working in a university hospital, to assess the perception of health and the uptake of prevention strategies in an optimal setting. A list of 13 diseases was submitted and the women were asked to list the five diseases they found to be the most important for a woman of their age. Breast cancer was ranked among the five most important diseases by 85% of the women and uterus cancer by 71.

The menopause in Europe.

Most women in developed countries will live a third of their lives after the menopause. Vasomotor symptoms (hot flushes, night sweats, irritability, sleep disturbances, mood swings), and urogenital complications (atrophic vaginal irritation and dryness, dyspareunia) occur frequently during this period of life, but their severity and duration may vary widely between individuals. The menopause also induces accelerated bone loss and is the principal risk factor for osteoporosis.

Osteoporosis management.

About 40% of women who reach the age of 50 are expected to suffer from osteoporosis during their remaining life. The morbidity associated with hip, spinal and wrist fractures, resulting from osteoporosis, and the mortality resulting from hip fractures justify the development of prevention strategies. Optimal management of osteoporosis consists of maximizing peak bone mass in early adulthood and preventing the rapid bone loss that occurs soon after the menopause.

Occurrence of gouty tophi following acitretin therapy.

Acitretin (Ro 10-1670 or Neotigason), a free acid and the main metabolite of etretinate (Ro 10-9359 or Tigason), is the most recent of the retinoids used orally in the treatment of psoriasis and numerous other dermatoses exhibiting disorders of keratinization. In the majority of cases, its side-effects are similar to those of hypervitaminosis A.

Techniques, Equipment, and Exposure for Endoscopic Retroperitoneal Surgery.

The videoendoscopic revolution has now reached the field of retroperitoneal surgery. However, safe retroperitoneoscopy demands perfect and detailed knowledge of the local anatomy. It also involves new dissecting techniques with new tools and specific strategies.

Inflammatory aneurysms of the abdominal aorta. Review of 7 cases.

Seven cases of inflammatory aneurysm of the abdominal aorta were reviewed. The authors discuss the different diagnostic modalities (ESR, CT-scan, IVU) and some peroperative technical details in the surgical approach to this pathology in order to lessen blood loss and prevent aorto-enteric fistulous complications.

Influence of suramin alone or in combination with DHT and PDGF on the cell proliferation of benign and malignant human prostatic tissues in organ cultures.

We studied the suramin-induced influence on the cell proliferation of 16 benign and 6 malignant lesions of the human prostate maintained in vitro as organ cultures. The cell proliferation was assessed by nuclear labeling with tritiated thymidine autoradiography. We also studied the dihydrotestosterone (DHT)-and platelet-derived growth factor (PDGF)-induced modulation of suramin influence on such prostate organ culture cell proliferation.

[Parenterally administered medium-chain triglyceride-induced changes in carnitine metabolism].

Medium-chain triglycerides are generally assumed to be metabolized independently of carnitine. The effects of infusing medium-chain triglycerides on plasma concentrations of carnitine derivatives and beta-hydroxybutyrate was studied in four healthy male adults. Glucose and amino acids were infused alone for three hours, then continued for another 5.

The interleukin-2 receptor on cord blood and nulliparous mononuclear cells is downregulated by maternal and cord blood serum.

The concentration of interleukin-2 receptor (IL-2R) on maternal, cord blood and unrelated nulliparous mononuclear cells has been studied after a previous phytohaemagglutinin (PHA) stimulation. Furthermore, the inhibitive action of maternal and cord blood serum on the IL-2R expression of stimulated nulliparous and cord blood lymphocytes has been shown. A downregulation of the [3H]-thymidine uptake by these PHA treated cells previously incubated in maternal and cord blood serum has been observed.

Modulation of class II histocompatibility antigen expression by maternal serum.

Human maternal serum has been shown to down-regulate the expression of MHC class II antigen in three distinct circumstances. Cord blood mononuclear cells, incubated in the mother's own serum, showed significant modulation of class II antigen expression. This was also the case for unrelated donor lymphocytes, incubated in pooled maternal serum.

Modulation of the interleukin 2 receptor by maternal and cord blood serum.

In this report, the potential inhibitive action, of maternal serum (retroplacental and peripheral), and cord blood serum on the expression of the Il2r has been studied. Calf and male serum were used as a control. In order to have an optimal Il2r expression, a previous PHA cellular stimulation was performed.

Carnitine deficiency with cardiomyopathy presenting as neonatal hydrops: successful response to carnitine therapy.

A small-for-date infant presented at birth with severe non-immune hydrops, cardiac failure, metabolic acidosis and hypoglycaemia. Ultrasonography disclosed a cardiomyopathy. Initial therapy consisting of artificial ventilation, inotropes and diuretics resulted in partial disappearance of oedema without significant improvement in cardiac function.

Detection of human papillomaviruses 16-18 in cervical cells by molecular hybridization: relationship with morphonuclear cell image analyses.

Forty-one Feulgen-stained cervical imprint smears were analyzed by means of the SAMBA 200 cell image processor in order to quantitatively score human papillomavirus (HPV) 16-18-induced morphonuclear modifications as assessed by morphometric, densitometric, and textural parameters. Molecular hybridization technology using 16 and 18 type specific genetic probes made it possible to divide our series into three groups: Group 1, containing noninfected smears; Group 2, containing "suspicious", i.e.

Staphylococcus aureus phagocytosis. A new cytofluorometric method using FITC and paraformaldehyde.

A new method for measuring the uptake of Staphylococcus aureus by human polymorphonuclear neutrophils (PMN) using flow cytometry (FCM) is described. Bacteria were labeled with fluorescein isothiocyanate (FITC) and incubated with PMN in a suspension assay. At the end of the assay, phagocytosis was arrested by the addition of cold paraformaldehyde.

Physiological cost of vocational activities after myocardial infarction.

Oxygen consumption was measured during 30 min of work in 16 patients, after a myocardial infarction (anterior or posterior), and compared with 16 normal subjects, of the same age, involved in the same activities, in a steel factory. The VO2 at work of the patients was a little lower than in normals. The mean heart rate for 8 h was also a little lower in patients than in normals.

Impaired neutrophil defense against Yersinia enterocolitica in patients with iron overload who are undergoing dialysis.

Increased risk that patients with iron overload who are undergoing dialysis will have bacteremia caused by Yersinia enterocolitica has previously been shown. Iron overload is known to increase the virulence of Y. enterocolitica.

Priorities in the management of polytraumatised patients with head injury: partially resolved problems.

The results of a retrospective analysis of a series of 73 polytraumatised patients with severe head injuries are presented. The neurological outcome has been less favourable in cases with early osteosynthesis of peripheral fractures compared to cases in which such operations had been delayed. Therefore it seems advisable to postpone the non-vital operative treatment of osteoarticular lesions until stabilisation of the cerebral and vegetative situation.

Neutrophil dysfunctions in thalassaemia major: the role of cell iron overload.

The susceptibility to infections was recorded in 13 patients with beta thalassaemia major (T.P.).