Prophylactic argon laser photocoagulation of the second eye in presumed ocular histoplasmosis syndrome.

Fifty-six patients with presumed ocular histoplasmosis syndrome who exhibited a disciform macular detachment or macular scar in one fundus and one or more inactive atrophic lesions within the high-risk area of the second eye were seen at the Retina Service of Maisonneuve-Rosemont Hospital, Montreal, between 1972 and 1984. All 56 were followed for at least 10 months. Of the 56, 28 had received prophylactic argon laser photocoagulation of the inactive chorioretinal lesions. The rate of activation of the lesions was similar in the treated and untreated groups (10/28 over a mean follow-up period of 44.2 months and 11/28 over a mean period of 43.2 months respectively). In the untreated group there was an increased risk of activation with a higher number of lesions (t = 2.386). In both groups the risk of activation increased with the proximity of the lesions to the centre of the fovea (chi 2 = 29.97). Of the 10 treated eyes that showed activation, 4 did so within 1 month, which suggests that prophylactic photocoagulation may not be without risk of complications.

[Relationship between some health indicators of physical, mental well-being and handicaps in the aged (author's transl)]. / Relations entre les indices épidémiologiques du bien-être physique, mental et de la dépendance chez les personnes âgées.

The health status of 1,025 senior urban citizens was determined by a questionnaire based on the subjects' view of physical, mental and global well-being and of dependency (indicators of Belloc and all., Berkman, Grogono and Woodgate, Linn). The significant correlation was observed between different health indicators. However, these correlations are not strong enough to allow the explanation of one indicator by the others. The mental well-being is most independent of all other health measurements under study. The valuable information on the prevalence of some health limitations in the population is given by the constituents of the health indexes used. On the contrary, a more complete view of the health of the population should be obtained by the non correlated methods of measurement. The situation may vary following the epidemiological characteristics of the population studied.

Principal component analysis of four health indicators and construction of a global health index in the aged.

The health status of 1025 urban senior citizens in a Montreal metropolitan area was determined by a questionnaire based on the subjects' view of physical, mental, and general well-being, and of dependence (indicators of Belloc et al., Berkman, Grogono and Woodgate, and Linn). A principal component analysis was made of these health indicators and two factors were retained. The first factor, which can be called a global health index, was used to compare the sexes and the age strata; it was thus found that men (those who survive) are generally healthier than the women, and that subjects from the lower-age strata are healthier than their older counterparts. The second factor is described as opposing physical health and dependence to mental health, the results of which were similar for both sexes, bur differed according to the various age strata compared.

Knowledge of medical students, pediatric residents, and pediatricians about the cost of some medications.

Medical students, pediatric residents, and pediatricians were asked to evaluate the cost of commonly prescribed medications. Their estimations varied considerably and were considered as adequate in 40%, 52%, and 62% of the cases, respectively. In most situations, the adequacy of their estimations did not seem to improve significantly with the length of training and practice. Since the cost of medications may influence compliance, it should probably be discussed more often during the course of medical and pediatric training.

Oral contraceptives and prolactinomas: a case-control study.

The increase in the number of newly diagnosed cases of prolactinomas seems to coincide with the use of oral contraceptives during the past two decades. The following retrospective case-control study was undertaken in an attempt to disprove a null hypothesis of relationship between oral contraceptive use and prolactinomas. Each of 70 patients operated upon for removal of a prolactinoma was closely matched for age, gravidity, and year of final diagnosis with one patient in each of three control groups. The control groups selected were constituted, respectively, of patients with secondary amenorrhea and normal prolactin levels, patients with normal ovulatory cycles consulting for infertility, and subjects without medical or gynecologic problems. No statistically significative differences were found in the exposure rates to oral contraceptives among four groups. This study thus failed to reveal a significant association between prolactinomas and oral contraceptives but, given the sample size, a relative risk lower than 3.32 cannot be demonstrated or disproved.

PIP: The increase in the number of newly diagnosed cases of prolactinomas seems to coincide with the use of oral contraceptives (OCs) during the past 2 decades. The following retrospectives case-control study was undertaken in an attempt to disprove a null hypothesis of relationship between OC use and prolactinomas. Each of 70 patients operated upon for removal of a prolactinoma was closely matched for aged, gravidity, and year of final diagnosis with 1 patient in each of 3 control groups. The control groups selected were constituted of patients with secondary amenorrhea and normal prolactin levels, patients with normal ovulatory cycles consulting for infertility, and subjects without medical or gynecologic problems. No statistically significant differences were found in the exposure rates to OCs among the 4 groups. Even the duration of OC use was not statistically significant in patients with prolactinoma and in patients with secondary amenorrhea and normal prolactin levels or patients with infertility. This study failed to reveal a significant association between prolactinomas and OCs but, given the sample size, a relative risk lower than 3.32 cannot be demonstrated or disproved. The results are reassuring and support the view that the increasing incidence of prolactinoma is probably due to advances in diagnostic technology rater than to OC exposure.