[Computerized processing, using a Macintosh, of ambulatory arterial pressure measurements collected on a Spacelabs monitor]. / Traitement informatisé sur Macintosh des mesures de pression artérielle ambulatoires recueillies sur moniteur Spacelabs.

UNLABELLED: The use of the Spacelabs blood pressure recorder has given rise to processing programs running on Apple II and IBM PC computers. The authors have written in M.S. BASIC (2.1) a program who take advantage of graphic abilities and easy manipulation on Macintosh. The software was designed to perform three tasks: Communicating between Macintosh and Spacelabs station using serial interface (RS 232) without requesting specific interface card. Editing a report on two pages: The first is the listing of 96 measurements (one by 15 minutes). The second provides: patient identification, height, weight, diagnosis. Graphic representation of measurements Systolic and diastolic blood pressure (BP) repartition histogram for 24 hours, day and night. Standard deviation and mean of pressure and heart rate (HR) for those periods. A third optionally gives hourly chronogram and diagrams for cumulated BP and HR. Creating a file: 550 records can be stored on a 800 K floppy disk. The file handles: data for each patient (excepted identification). Random access and revision of each parameter is possible. SYNTHESIS: comparative reports for group patients and patient by patient analysing data with appropriate statistical test (ANOVA and correlation) are done.

[Nycthemeral blood pressure monitoring in the diagnosis of borderline arterial hypertension in young adults]. / Apport de l'enregistrement tensionnel nycthéméral au diagnostic de l'hypertension artérielle limite de l'adulte jeune.

PURPOSE: Evaluating Blood Pressure Monitoring contribution at rest to the diagnosis and pathophysiology of borderline (BL) hypertension in the twenties. METHOD: a nycthemeral blood pressure recording each 15 minute has been performed during the 48 first hours of hospitalisation on two groups of white twenties males with a Dinamap: 143 CONTROLS. Mean age: 21.1 +/- 2 yrs, mean height: 177 +/- 7 cm, mean weight: 71 +/- 11 kg; 104 BL hypertensive patients. Mean age: 21 +/- 2 yrs, mean height: 178 +/- 7 cm, mean weight: 78 +/- 12 kg. Mean BP recording levels are smaller than casual measurements in two groups: CONTROLS (Casual BP: 125/71, BP recording on 24 hours: 117/60, day time: 121/63, nighttime: 110/54 mmHg). BL hypertensives (Casual BP: 144/83, BP recording on 24 h: 132/69, daytime: 137/73, nighttime: 121/60 mmHg). Nycthemeral BP variability measured by the standard deviation of mean pressure is not different in two groups for systolic variability, it significantly differs for diastolic variability (BL: 7.6/CONTROLS: 5.5, p less than 0.01). Correlations between casual BP and diurnal records are stronger in controls than in BL patients showing a lower predictive value of clinical assessment in BL patients. Though the same heart rate at sleep, BP is significantly higher in BL than in controls. It probably means that factors different from sympathetic activity are involved in pathophysiology of borderline hypertension. The whole measurement study on 24 hours of two groups show an important overlap (the 65th percentile in BL systolic BP correspond with the 95th of controls, the 74th percentile in BL diastolic BP correspond with the 95th in controls). That make difficult the recording evaluation for a given patient.

[Plasma viscosity and erythrocyte filterability in borderline hypertension]. / Viscosité plasmatique et filtrabilité érythrocytaire au cours de l'HTA limite.

Hemorheological constants (plasma viscosimetry and erythrocyte filtrability index) were studied in 153 male subjects aged 19 to 23. Borderline hypertension defined by clinical criteria was found in 61 of these patients. Whilst there was no notable modification in plasma viscosity, by contrast there was a significant link between erythrometry and systolic and diastolic blood pressure. Erythrocyte deformability was all the more marked as blood pressure rose. These results would contrast with findings in the literature in cases of definite hypertension. The borderline nature of hypertension and the youth of the population was such that it could be considered that barometric factors had not yet influenced erythrocyte filtrability. The following hypothesis is therefore attractive: initially the red cell adapts itself to any possible increase in peripheral resistance. As the years go by its deformability is lessened by adverse changes affecting its membrane cytoskeleton.

[Treatment of Horton's disease]. / Le traitement de la maladie de Horton.

716 cases collected from 9 recent studies published between 1981 and 1985 served as a basis for a general review of the current treatment of temporal arteritis. Steroid therapy was instituted as first intention in 652 cases, high dose treatment was continued for between 8 days and 3 months but the majority of authors started a reduction in the dosage from the 4th or 5th week. There was no overall agreement regarding the duration of maintenance therapy nor the criteria allowing its discontinuation, and withdrawal was not possible before the 25th month on average. The ideal initial dosage, in the absence of randomized studies, remains to be defined: generally around 0.5 mg/kg/d in milder forms, the dosage may be increased to 1 mg/kg/d in the presence of complicated temporal arteritis. Besides cortico steroid therapy, other treatments are successively envisaged: synthetic anti-malarials (SAM), non steroidal anti-inflammatories (NSAI), dapsone... while these are generally used as back-up treatment, David-Chausse used SAM as first intention, combined in 17 cases with NSAI in 61 of his 66 patients, with very promising results which require confirmation in other studies. In this review the cure rate was around 25% and the relapse rate 38%; complications related to the disease occurred in 19%, while almost one patient in two--47%--developed iatrogenic complications. Blindness dominates the prognosis, and occurred in 15% of cases, most often as an inaugural event, it very rarely regressed on steroid treatment. Although death occurred in 18% of cases, the prognosis of temporal arteritis generally remains favorable, with a 5 year survival curve identical to a control population.

[The influence of anthropometric factors, hemorheologic parameters and the level of arterial pressure on pulse wave velocity]. / Influence des facteurs anthropométriques des paramètres hémorhéologiques et du niveau de la pression artérielle sur la vitesse de propagation de l'onde de pouls.

UNLABELLED: The measurement of the pulse wave velocity (PWV) is widely used in clinical practice to assess the elasticity of the arterial system. It can be influenced by a number of factors. The present study was undertaken to assess the possible role of anthropometric factors, hemorheological parameters and blood pressure on this element. STUDY DESIGN: Sixty-three male subjects, mean age: 21 +/- 1.6 years,; height: 177 +/- 7 cm; weight: 76 +/- 13 kg, were subjected to Doppler measurement of the carotid-femoral PWV with synchronous recording of blood pressure. In parallel, the following were carried out: nycthemeral blood pressure recording, measurement of plasma vicosity and erythrocyte deformability, determination of hematocrit, fibrinogen and total proteins. The Quetelet indices and body surface area (BSA) were calculated for each patient. These data were analyzed by multiple linear regression. RESULTS: Three parameters affect PWV: 24-hours diastolic blood pressure, hematocrit, and body surface area (the coefficient of multiple correlation: r = 0.597, the percent variability of the explained variable is equal to 35.7%, the regression equation can be written: PWV CF (cm/sec) + 0.283*Diast/24 hours + 0.742* hematocrit + 9.486* BSA = 0.629). The following parameters are not involved: plasma viscosity, erythrometry, total proteins, fibrinogen, Quetelet index, systolic and diastolic blood pressure during the investigation, mean systolic pressure and mean heart rate over 24 hours. COMMENTS: The PWV-diastolic pressure relationship is well-known. In contrast, the effect of the hematocrit and body surface area has never been reported.(ABSTRACT TRUNCATED AT 250 WORDS)

[Arthritis and palmoplantar pustulosis]. / Arthrites et pustulose palmo-plantaire.

Pustulosis palmaris et plantaris may be associated with a number of articular diseases. Known to be present in Fiessinger-Leroy-Reiter syndrome and psoriasis arthropatica, this skin disease has been classified by Japanese authors as a new nosological entity: pustular osteo-arthritis. Pustulosis palmaris et plantaris seems to represent a meeting point for axial rheumatisms close to ankylozing spondylitis.

[Renal hydatid cyst. Contribution of radiology apropos of a case]. / Kyste hydatique rénal. Apport de la radiologie à propos d'un cas.

Hydatid disease, an infestation of gastrointestinal origin, is essentially localized in the two principal filters of the body, the liver and the lung (80% of localizations); 20% correspond to a random distribution (brain, bones, kidneys, etc.). The observation of a new case of rare renal infestation (1 to 5% of all hydatid cysts) constitutes an occasion to review the role of various radiological investigations in this disease. Computed tomography has a role in the diagnosis which is complementary to that of plan abdominal x-rays and ultrasonography. Intravenous pyelography may be performed subsequently. It has an essential role in the systematic investigation of other localizations.

[Hemorrhage caused by rectal varices and portal hypertension]. / Les hémorragies par varices rectales et hypertension portale.

Hemorrhage from rectal varices due to portal hypertension is an exceptional finding (23 cases published), and arises as a result of derivation of hepatic blood flow into the inferior mesenteric vein (superior hemorrhoidal vein) associated with rectal vein dysplasia. A case is reported in a known cirrhotic.

[Digital microembolism disclosing intracardiac thrombosis]. / Microembolies digitales révélatrices d'une thrombose intracardiaque.

The authors report the observation of a 46 year old man with a case history of myocardial infarction at the age of 26 years, transient ischemic injury at 41 years of age, and in whom a focalised digital ischemic syndrome of microembolic nature led to the discovery of an intracardial thrombosis which was operated upon and progressed without complication. Bloody microembolisms of cardiac origin may be selectively revealed by acrosyndromes, the diagnostic elements of which are mentioned. They are poorly understood conditions. Their significance must not be neglected because of the risk of recurrence in macroembolic form. The pathogenesis of these obstructions and their specific responsibility for ischemic cardiopathies is reviewed. It is appropriate to emphasise the novelty of this observation since, in the context of ischemic cardiopathies, no attention has been devoted to microembolisms, in contrast to the numerous publications relating to macroembolisms. The symptomatic treatment is unremarkable, the etiological treatment of intracardial thrombosis is discussed.

[Role of dapsone in the treatment of Horton's disease and polymyalgia rheumatica]. / La place de la dapsone dans le traitement de la maladie de Horton et de la pseudopolyarthrite rhizomélique.

The authors report 8 cases of Horton's disease and/or polymyalgia rheumatica treated with prednisone with an initially favourable result. However, the disease progressed despite relatively high dose steroid therapy, complications of which contraindicated increasing the dosage and even necessitated rapid withdrawal of steroids. The association of dapsone 100 mg/day orally had a rapid favourable effect in all 8 cases. However this treatment was well tolerated in only 3 patients and could only be continued in 4 out of the 8 cases. Manifestations of intolerance (methemoglobinaemia) rapidly regressed after withdrawal of dapsone but this was followed by another exacerbation of the disease, resulting in a therapeutic impasse. Despite the incidence of these iatrogenic complications, dapsone would appear to provide a therapeutic option in patients with Horton's disease and/or polymyalgia rheumatica resistant to high dose steroid therapy or in whom complications of steroid therapy impose a reduction in dosage or complete withdrawal of the drug.

[Major orofacial manifestations of Kaposi's disease. Apropos of a case report]. / Manifestations bucco-faciales majeures d'une maladie de Kaposi. A propos d'une observation.

After observing a case of Kaposi disease with major oro-facial manifestations, the authors draw a certain number of considerations which lead them to express an etiopathogenic hypothesis concerning this disease. An autoimmune conflict might be produced, along with the emergence of an oncogene virus.