[Development of a standardized form for mercury gauge plethysmography of veins and arteries]. / Mise au point d'une fiche de compte rendu standardisé pour les examens pléthysmographiques à jauge de mercure veineux et artériels.

Mercury strain gauge plethysmography will play an increasingly important role in vascular function exploration, participating in the detection of deep vein thrombosis and replacing arteriopathy in its arterio-capillary context. This required the development of a standardized reporting form for entering results of venous and arterial examinations and providing simple, clear evaluations of vascular function to assist therapeutic decisions. A standardized sheet in the form of rapidly scanned graphs and tables was established, this simplified representation facilitating decision making. Wider use of this type of form is proposed, with the aim of providing uniformity of data from mercury strain gauge plethysmography and statistical and computerized analysis of results of multicentre studies.

[A survey of the French-speaking Association of Lymphology on the use of pressotherapy in France during the treatment of lymphedema]. / Enquête de l'Association de Lymphologie de langue française sur la pratique de la pressothérapie en France au cours du traitment des lymphoedèmes.

116 physicians out of the 1000 who were questioned use pressure-therapy in the treatment of lymphedema of the extremities. Another 170 are interested in the technique and await this report before possibly adopting it. Overall, the devices utilized are compartmented and use discontinued pressure that is asynchronous in relations to heart beat; each session lasts 30 minutes, on average, with compression and resting phases lasting 45 seconds and 15 seconds, respectively. The usual schedule is one session daily, three days per week, in two series clustered within a single year. Although manual drainage of lymphatics is combined with pressure-therapy in 71.55% of the times, only 43.47% of physicians use elastic support following the treatment. Results are good or very good in 64.4% of cases, and the incidence of post-therapeutic events is rather low (polyuria, pain recrudescence of lymphangitis, etc.). Aside from lymphedema, venous insufficiency, hypodermitis and leg ulcers may also benefit from pressure-therapy.

[Study of the plethysmographic amplification factor during vasodilator treatment. Healthy subject versus primary Raynaud phenomenon]. / Etude du facteur d'amplification en pléthysmographie sous traitement vasodilatateur. Sujet sain versus phénomène de Raynaud primaire.

Digital arterial circulation before and after administration of a vasodilator orally was explored by mercury gauge pulsed plethysmography and photoplethysmography in 12 patients with primary Raynaud's phenomenon and results compared with those of 10 healthy volunteers. The amplification factor F, ratio of amplitude in reactive hyperemia over amplitude at rest was determined in the index before and after 8 mg daily of dihydroergokryptine over 4 weeks. Before treatment, for each of the two plethysmographic technics, a significant increase in mean factor F values was noted in the patients with Raynaud's phenomenon when compared with healthy controls. This is due to a decline in digital arterial flow at rest. Using the mercury gauge plethysmograph, a significant reduction in factor F was observed after vasodilator treatment corresponding to an increase in digital flow at rest without increase in flow during hyperemia. Using photoplethysmography, no significant variation in factor F was noted after treatment. Mercury gauge plethysmography, which measures global digital blood flow appears to be a more sensitive method than photoplethysmography, which measures dermal and hypodermal blood flow, for follow-up of effects of vasodilator treatment on Raynaud's phenomenon.

[Therapeutic management of superficial venous thrombosis with calcium nadroparin. Dosage testing and comparison with a non-steroidal anti-inflammatory agent]. / Traitement curatif des thromboses veineuses superficielles par nadroparine calcique. Recherche posologique et comparaison à un anti-inflammatoire non stéroïdien.

This multicentre, randomised, open trial compared the efficacy and safety/acceptability of calcium nadroparin, a non-steroidal anti-inflammatory drug, naproxen, in the treatment of superficial venous thrombosis of the lower limbs, in 117 patients. Calcium nadroparin was given at two dosage regimens: a fixed dose (daily subcutaneous injection of 0.6 ml, i.e. 6150 anti-Xa IU, n = 38) or a dose adjusted for body weight (31.5 anti-Xa IU/kg, n = 40). The naproxen was given orally (500 mg as a single daily dose, n = 39). Treatment duration was 6 days in both groups. A very marked difference was found to the advantage of calcium nadroparin, although this difference did not reach the threshold of statistical significance with regard to repermeabilisation of the thrombosed superficial vein at the end of treatment. The most striking result concerned the regression of symptoms and signs. At the end of treatment (D7), there was a significant difference to the advantage of the calcium nadroparin groups, particularly regarding feelings of heat and redness (p < 0.001 in both cases). The persistence of symptoms and signs at 8 weeks was statistically less frequent (p = 0.007) in the calcium nadroparin groups than in the naproxen group. Efficacy did not differ between the calcium nadroparin fixed dose and calcium nadroparin weight-adjusted dose groups. No adverse events nor clinically significant laboratory abnormalities were encountered. Antithrombotic treatment of superficial venous thromboses with calcium nadroparin is well tolerated and appears to be associated with a greater improvement in symptoms and signs, in the short and mid-terms, than that obtained with an oral non-steroidal anti-inflammatory.

[Lipoatrophia semi-circularis of the thigh]. / La lipo-atrophie semi-circulaire des cuisses.

Two typical cases of this apparently rare condition usually observed in women are reported. 22 cases have been published since the first observation in 1974. Lesions are made of semi circular band-like, isolated, atrophy of the subcutaneous fatty tissue, involving half the circumference of anterolateral part of the thigh. No other clinical or biological abnormalities are noticed. Four stages may be histological considered. Ultrastructural investigation performed in our cases confirms histological findings: in the first case adipocyte's abnormalities, fibrillogenesis, and sclerosis are noticed, in the second case (persistent lipoatrophia) rarefaction of collagen's fibers appears to be the most important feature. Etiology remains unclear, but repeated external traumas seem the most plausible explanation in several cases of the literature and in our cases: case no. 1, related to leaning on bath's border for washing, was regressive after trauma's suppression, while the second case was not regressive since the patient did not discontinue wearing the responsible girdle.