[The OSCAR registry. Registry of acute coronary syndromes]. / Observatoire OSCAR. Observatoire des syndromes coronaires aigus.

The aim of the OSCAR observatory was to describe the medical management of patients hospitalised for acute coronary syndrome (ACS). Demographic characteristics, risk factors, history of cardiovascular events, diagnostic and therapeutic procedures on admission and during the stay in hospital were recorded. From september 2000 to february 2001, 869 patients with acute coronary syndrome were enrolled in this survey. This sample of patients is quite similar to the one usually described in such studies with a male/female ratio of 2.7 and a mean age of 66. The initial diagnosis at entry was: 23.6% patients with unstable angina, 34.4% patients with myocardial infarction with ST elevation, and 42.0% of patients with myocardial infarction without ST-elevation. Troponins were used in 65% patients for troponin I, 13% for troponin T and should be more widely used. Whatever the inclusion diagnosis, planned procedures or biological data, only 25% of hospitalized patients for acute coronary syndrome were treated with anti-GPIIb/IIIa. This rate of treatment was lower than expected by the guidelines published by Societies of cardiology.

[Coverage of pointed acute coronary syndromes in the general hospital centers]. / Prise en charge des syndromes coronariens aigus dans les centres hospitaliers généraux. Résultats du registre RICA 2000.

This study presents data on the management of acute coronary syndromes collected in a national registry organized by the french Collège national des cardiologues des hôpitaux généraux in September 2000. In all 86 institutions participated and data from 607 patients (mean age: 67 years; 413 men) were analysed. The final diagnosis was unstable angina in 38%, non-Q wave myocardial infarction in 21% and Q-wave myocardial infarction in 40.5%. Median time to admission was 4 h. At symptom onset, patients called their general practitioners in 46% of cases, emergency ambulatory units in 31% of cases and arrived to the hospital on their own in 23% of cases. Observance of the European Society of Cardiology guidelines was good for patients without ST segment elevation. In patients with ST segment elevation, 9% had pre-hospital thrombolysis, 28% hospital thrombolysis, and 27% had angioplasty within 48 h of admission, including 9% with rescue angioplasty. Overall, 57% of patients with ST segment elevation received reperfusion therapy. In hospital mortality was 6% for the whole cohort, and 11% for patients with acute myocardial infarctions. By multivariate analysis, predictors of in-hospital mortality were age, type of acute coronary syndrome, absence of beta-blocker therapy, and absence of coronary angiography.

Improvement of nutritional status in cholestatic children with supplemental nocturnal enteral nutrition.

Protein energy malnutrition is a common complication in cholestatic children in a hepatic transplant program, and may be detrimental to the postoperative outcome. Improvement of the nutritional status may be of obvious importance to improve the prognosis. This study compared oral nutrition with oral nutrition supplemented with nocturnal enteral feeding in children with prolonged cholestasis. In six children with prolonged cholestasis (conjugated bilirubin over 25 mg/L and/or GGT over 110 IU/L in infants aged less than 3 months or over 50 IU/L in older infants and/or alkaline phosphatase over 500 IU/L, for more than 3 months), we compared a 4 to 6 month period with oral nutrition and similar periods with 10 to 12 h nocturnal enteral feeding given at home as an energetic supplement. Energy intake during the second period was 180-200% of recommended dietary allowances. No ascites was found in the six patients during the study period. The Z scores of body weight, weight expressed as percent of ideal body weight (IBW), weight/height2, and arm circumference/head circumference were calculated at the beginning and at the end of each period. With only oral nutrition, a diminution in percentage of ideal W/H and a diminution in Z score for the body weight were observed in five of six patients. At the end of the second period, the average of all of the nutritional indexes was increased and the Z score for the body weight was also increased in four of six patients. Significant statistical differences (p less than 0.05) were found in W as percentage of IBW and the Z score for log W/H2.(ABSTRACT TRUNCATED AT 250 WORDS)