[Value of continuous monitoring of the electrocardiogram in asymptomatic subjects]. / Intérêt de l'enregistrement continu de l'électrocardiogramme chez le sujet asymptomatique.

The authors analysed the prevalence of atrioventricular conduction defects and sinus node dysfunction by Holter monitoring in three population groups with similar clinical characteristics: 50 controls (Group I), 17 physically fit subjects with an atrioventricular conduction defect on the resting ECG which was usually asymptomatic (Group II), and 48 professional pilots who were also physically fit but who had no conduction defects on resting ECG (Group III). The 24 hour recordings showed: --a similar incidence of sinus dysrhythmias and atrioventricular conduction defects in the three groups although the frequency of low degree block was a little higher in sportsmen; --a preponderance of the association of first degree block and nocturnal Luciani-Wenckebach periods, sometimes with episodes of Mobitz II block; --the absence of progression to high-degree atrioventricular block. Holter monitoring would therefore seem to be a good method of detecting and following up abnormalities of sinus node function and atrioventricular conduction defects in asymptomatic patients. In addition, it gives a qualitative and quantitative assessment of the recorded changes and provides a means of monitoring their evolution.

[Mechanism of clinical onset and outcome of coronary disease before 40 years of age. 148 cases]. / Mode de début clinique et devenir de la maladie coronaire avant 40 ans. 148 observations.

This study reviewed the clinical histories of 148 coronary patients aged 34 +/- 5 years (20-40 years) documented in the same cardiology unit. Myocardial infarction was the presenting condition in 114 patients (77%): inaugural 65%, with prodrome 7%, asymptomatic 4%. The presentation was angina pectoris in 32 patients (22%): effort angina 15%, unstable angina 7%. Two patients had other symptoms (1%). The coronary lesions were significant (greater than 50%) in 112 patients (77%) which included 41% single vessel diseases and 36% multiple vessel diseases. The coronary lesions were insignificant in 10 patients (7%) and absent in 21 (15%) (33% under and 11% over 30 years of age). After an average follow-up of 48 months (range 1 to 10 years), 20 of the 32 patients presenting with angina developed myocardial infarction and 6 had episodes of unstable angina (65% in the first year following diagnosis). Six patients had no serious coronary events, but thereafter, 3 died. Fifteen patients (47%) are asymptomatic (including 8 after coronary bypass surgery). Ten patients are symptomatic. Of the 114 patients with inaugural myocardial infarction, 3 have died, 67 (58%) are symptomatic; the average number of risk factors per patient was related to age and to the degree of coronary artery disease. The left ventricular ejection fraction was significantly higher in asymptomatic patients than in those who had presented a coronary event after myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

[Risk factors for transmissible cardiovascular diseases]. / Les facteurs de risque cardiovasculaire transmissibles.

Atherosclerosis is a multi-factor disease representing a real plague for developed countries, and spreading at an increasing rate in third world nations. In industrialized countries, coronary pathology occupied the first place in terms of morbidity and cardiovascular mortality, affecting more and more frequently younger people, thus constituting a serious problem of public health. Therefore, it seems absolutely necessary to carry out systematic screening for atherosclerosis amongst all high cardiovascular risk families groups, from infancy onwards. Lacking knowledge about the exact cause of atheroma, we had to determine what are commonly called the factors of cardiovascular risk. Among these, some are transmissible. Transmission may be direct: genetic and hereditary factors (sex, race, antecedents, dyslipemia, high blood pressure, diabetes) but it may also concern the transmission of a way of life. To prevent ischaemic heart disease, it is necessary to bring out change in behaviour from infancy onwards to detect high risk subjects and to correct every factor of cardiovascular risk upon which an action is possible.

Cardiac arrhythmias in space. Role of vagotonia.

Rhythm disorders observed in space have always been minor but they are not unfrequent. They include: ventricular or supra-ventricular extrasystoles, nodal arrhythmias, auriculo-ventricular conduction disorders. There are several etiopathogenetic hypotheses: a strict selection must permit its elimination of an underlying heart disease; the potassium deficiency is often advanced but its role is not certain; the role of catecholamines is also discussed; the role of hypervagotony is extensively analysed as great clinical and electro-cardiographic evidence speaks for it. It can induce disorders which are more serious than those observed so far, particularly fibrillation or intermittent atrial flutter; weightlessness itself could partly condition the vagotonic state; and the effects of fluid shifts are also discussed from this point of view. The possible therapies for various atrial, nodal, ventricular disorders are reviewed, with greater detail for vagal atrial arrhythmias.

[Proprioception changes induced by prismatic glasses wear in children suffering from developmental dyslexia]. / Etude de l'impact du contrôle postural associé au port de verres prismatiques dans la réduction des troubles cognitifs chez le dyslexique de développement.

PURPOSE: To evaluate the consequences of proprioception changes induced by a postural treatment on cognitive disturbances in children suffering from developmental dyslexia. MATERIAL: and methods: Twenty male dyslexic children were treated with prisms within their spectacles and a postural treatment. A control group of dyslexics (n=13) only received spectacles without prisms. All participants were evaluated at the beginning of the study and 6 months later with reading impairment tests and postural examinations. RESULTS: Mean age was 11 years and 5 months in the treated group and 11 years and 7 months in the control group. Four children were excluded from the 6-month analysis because of poor compliance. All dyslexic children presented with a postural deficiency syndrome. In 13 out of 16 treated children, dyslexia was improved at 6 months, especially for the global leximetric test and the reading of regular and irregular words. However, the treatment did not allow a complete recovery of reading ability when compared with age-matched individuals. CONCLUSION: Our results show that postural modifications may favorably influence some clinical signs associated with developmental dyslexia. Further studies with a larger sample and with a longer follow-up period are required to better assess the role of postural treatment in developmental dyslexia.

[Ocular proprioception and developmental dyslexia. Sixty clinical observations]. / Proprioception oculaire et dyslexie de développement. A propos de 60 observations cliniques.

PURPOSE: The objective of this study is to assess proprioception anomalies in postural deficiency syndrome in a group of children suffering from reading impairment. MATERIAL AND METHODS: Sixty male patients with an average age of 11 years and 9 months were included in the study. Initially, they were given a standardized neuropsychological examination, which confirmed the diagnosis of reading impairment. Then after filling out a questionnaire seeking a proprioceptive anomaly, the patients were subjected to a clinical ocular and postural examination consisting of nine precisely described steps. RESULTS: All of the patients recruited for the study presented clinical signs confirming a proprioception disorder found as a part of postural deficiency syndrome. CONCLUSION: This study opens a new direction for research concerning the origin and treatment of at least some reading-impaired children.

[Malignant pheochromocytoma]. / Phéochromocytome malin.

A case of metastatic malignant pheochromocytoma which was operated on is discussed. The benefits derived from the most recent localizing techniques such as CT scan and MIBG scintigraphic scanning are stressed. In the case presented these enabled the adrenal tumor to be detected but also demonstrated the presence of a costal metastasis and two metastases in the axial skeleton. A therapeutic trial with MIBG at doses of 100 mCi per treatment only enabled a survival of a little more than one year to be achieved.

[Etiological study of 23 cases of complete block of the left branch of the bundle of His, in the absence of myocardial infarction]. / Etude étiologique de 23 cas de bloc complet de la branche gauche du faisceau de His, en dehors de l'infarctus du myocarde.

An aetiological study was performed in 23 asymptomatic patients with left bundle branch block (LBBB) which included Thallium 201 myocardial scintigraphy on effort and, in 15 cases, cardiac catheterisation and coronary angiography. Thallium fixation was abnormal in all patients, but the cause of LBBB was attributed to cardiomyopathy in 9 cases, and to coronary artery disease in 2 cases. Cardiac catheterisation was normal in 4 cases. The hypofixation of Thallium 201 in LBBB can be explained either by an abnormality of left ventricular contraction due to heterotopic propagation of the depolarisation or by the unusually high incidence of the association of LBBB and left main coronary artery stenosis and/or a dominant left coronary artery. The practical implication of this study is that Thallium 201 myocardial scintigraphy is of little value in patients with LBBB.