[Functional thyroid pathology in the elderly]. / Enfermedad funcional tiroidea en la población de edad avanzada.

OBJECTIVE: To describe the prevalence of functional thyroid pathology (FTP) and pathologies associated with it in an elderly population. DESIGN: Descriptive, cross-sectional study. SETTING: Urban primary care centre. PATIENTS: Representative sample of the entire population attended that was 60 years old or over. MAIN MEASUREMENTS: Demographic variables, clinical history of thyroid pathology and pathology associated with it, Body Mass Index, small tests for diagnosing depression and anxiety, the mini-mental test, electrocardiogram, determination of total cholesterol and LDL cholesterol, and of free thyrotrophin and thyroxin if it is disturbed. RESULTS: 192 people were studied, 56% women, 53% between 60 and 69 and 12% over 79 years old. 10% had a history of previous FTP. Prevalence of active FTP was 13% (10.41% sub-clinical hypothyroidism, 0.52% clinical hypothyroidism, 1.56% sub-clinical hyperthyroidism, and 0.52% clinical hyperthyroidism). Prevalence of new diagnoses of FTP was 4.1% (7 with hypothyroidism and 1 with hyperthyroidism, all sub-clinical). During the study the following pathology was detected in hypothyroidism sufferers: 43% anxiety disorder, 38% depressive syndrome, 28.5% cognitive deterioration, 9.5% dementia, 26% electrocardiographic disturbances, 47.6% obesity, and 28.5% with total cholesterol > or =250 mg/dL. In hyperthyroidism, 50% with depressive syndrome, 25% with cognitive deterioration, 25% with electrocardiographic disturbances, and 50% with obesity were detected. CONCLUSIONS: FTP is more prevalent among the elderly than in the population as a whole, with predominance of hypothyroidism, subclinical pathology and among women. In terms of pathology traditionally linked to thyroid malfunction, few differences were found between the population affected with FTP and those not affected. Primary care doctors are important in reducing under-diagnosis.

2,3-di-n-decyloxy-6,7-dichloroanthracene (Cl2DDOA), a new low-molecular-mass fluorescent organogelator: physical properties and structures.

To extend the family of 2,3-didecyloxyanthracene (DDOA, 1), an organogelator having a rodlike shape, a high polarity, and fluorescing properties, the 6,7-dichloro derivative (Cl2DDOA, 2), was designed and prepared. Compound 2 forms gels in alcohols, nitriles, and alkanes. The electronic absorption spectra of the gel show a finer structure than those of the isotropic solutions, pointing to a specific degree of packing of the molecules; such an aggregation mode is also supported by fluorescence data. The gel-to-sol temperatures (Tm) were determined as a function of gelator concentration and the corresponding enthalpies (DeltaHm) were extracted. Scattering experiments have shown that the molecular packing in aggregates of 2 organogels is less reminiscent of the crystalline state than was the situation with DDOA gels. 2 organogels in butanol are made up of 120 A radius fibers much thinner than those observed in DDOA gels (r ca. 300 A) and with rather monodisperse cross sections. In 1-octanol, dodecane, or cyclohexane, the fibrillar organogel networks involve a broader distribution of the related cross sections through anisometric sections of the fibers and/or formation of bundles.

[A one-year prospective and intensive pharmacovigilance of antilipemic drugs in an hospital consultation for prevention of risk factors]. / Un an de pharmacovigilance prospective et intensive des médicaments hypolipidémiants dans une consultation hospitalière de prévention des facteurs de risque.

Cholesterol-lowering drugs include three major pharmacological classes: a) fibrates, b) statines, HMG-CoA reductase inhibitors and c) cholestyramine. The late eighties were characterized by the introduction of HMG-CoA reductase inhibitors in therapeutics. For 12 months (1st January-31 December 1991), a prospective intensive program of pharmacovigilance investigated the occurrence of side effects among the three pharmacological classes of cholesterol-lowering drugs in a specialized unit for prevention of atherosclerosis and dyslipidemia. Among 3,506 out patients who received cholesterol-lowering drugs, 36 side effects were reported (i.e. 1 side effect for 98 out-patients). Most of the side effects were observed with statines (61%). The most frequently observed side effects were gastralgia (19.5%) observed with the three classes of drugs and hepatitis with HMG-CoA reductase inhibitors (8.5%) or fibrates (3%) whereas myopathy (12%) only occurred with statines. The other side effects were cutaneous (14%: eczema, skin rashes) or neuropsychiatric (11%: insomnia...) ones. This study emphasizes the low frequency of severe side effects (myopathy: 1 per 1,000 prescriptions, hepatitis: 1 per 1,000 prescriptions) with cholesterol-lowering drugs in current practice.

[Drug consumption in a retired population]. / Consommation médicamenteuse d'une population de retraités.

Drug consumption has been studied in a population of 187 retired people, the average age being 66.5 years. The retired subjects are great drug consumers: 89% regularly take one (or several) drug(s). The central nervous system drugs are the most used (52%). Those of cardiovascular system are used by 46% of subjects. Females take more anxiolytic drugs and paracetamol than males who use more calcium channel blockers. Polymedication is usual and in opposition to working population, retired people are less addicted to self medication.

[Extrapyramidal syndromes caused by flunarizine. Apropos of 6 cases]. / Syndromes extrapyramidaux induits par la flunarizine. A propos de 6 observations.

The ability of flunarizine in inducing or worsening extrapyramidal symptoms is well documented. The relation with age or dose of such symptoms as their clinical characteristics remain controversial. We report 6 cases of extrapyramidal syndromes induced by flunarizine in five women and one man (mean age 71.5 +/- 5 years). The daily dose was 10 mg in five cases (as recommended by the marketing laboratory) and 20 mg in one patient. These observations allow to discuss the dose-dependent occurrence of this adverse reaction. In only three cases the reason for treatment was compatible with the official french indication. These side effects appeared after 7.0 +/- 1.6 months and disappeared after 2.2 +/- 0.5 months respectively. Flunarizine-induced extrapyramidal symptoms are mainly characterized by tremor (which was the main symptom in 4 cases and the only one in 2 cases).