Seasonal variation in chronic heart failure hospitalizations and mortality in France.

BACKGROUND: Circannual variation in blood pressure and in the incidence of acute myocardial infarction is well known but has not been investigated in chronic heart failure. This report describes and compares the seasonal variation of chronic heart failure hospitalizations and mortality in the French population. METHODS AND RESULTS: All deaths that occurred among French adults over the period 1992 to 1996 (n=138 602) and all discharges by adults in French public hospitals for chronic heart failure over the period 1995 to 1997 (n=324 013) were examined retrospectively. First, chronic heart failure deaths in France occurred with a striking annual periodicity and peaked in winter (December through January), both in the overall population and in subgroups defined by age (>44 years old) and sex. The distribution of cumulative monthly deaths differed by nearly 35%, ranging from a peak of 20% above average in January to 15% below average in August (Roger's test: P<0.001). Second, hospitalizations for chronic heart failure in French public hospitals followed a similar seasonal pattern (P<0.001), with a winter-spring predominance (+7% to +10% from December through April). Third, for persons >/=85 years old, excess hospitalizations occurred earlier in the year, with marked synchronized peaks in January for both mortality and hospitalizations (P<0.001). CONCLUSIONS: Clear seasonal variations in adult chronic heart failure hospitalizations and deaths were identified. The considerable economic impact on health care services warrants further epidemiological investigations and a more comprehensive approach to disease management.

Seasonal variation in cryptogenic and noncryptogenic hemoptysis hospitalizations in France.

STUDY OBJECTIVE: To determine the potential role of seasonality in hospitalizations for cryptogenic and noncryptogenic hemoptysis in the French population. DESIGN: Retrospective analysis of hospital discharge data from a National Register. SETTING: All 29 French university hospitals, between July 1, 1994, and June 30, 1997. PATIENTS: Two thousand six hundred seventy-seven and 3,672 adult hospitalizations for cryptogenic and other hemoptysis, respectively. MEASUREMENTS: Cumulative monthly averages were determined, expressed as the percentage above or below the average monthly value during the entire study period. RESULTS: The distribution of cumulative monthly hospitalizations for cryptogenic hemoptysis peaked in March (32% above the average) and was lowest in summer (30% below the average; p < 0.001). Hospitalizations for noncryptogenic hemoptysis followed a similar seasonal pattern (p < 0. 001). In the 16- to 34-year-old individuals, cryptogenic hemoptysis, compared with noncryptogenic hemoptysis, showed a higher incidence with a larger seasonal amplitude (p < 0.001). CONCLUSIONS: A better understanding of the fundamental pathophysiologic mechanisms underlying this respiratory and hemorrhagic condition may be helpful in developing preventive measures, especially in patients with a risk of recurrence.

Hepatic abscess caused by Brucella US, CT and MRI findings: case report and review of the literature.

The authors describe the findings detected by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) in a 42-year-old patient with a hepatic abscess due to brucellosis. This localization by Brucella (hepatic brucelloma) is quite rare and very often is asymptomatic. A review of the medical literature shows only 40 cases of an hepatic abscess due to brucellosis. The findings demonstrated by US, CT and MRI can offer important diagnostic elements, albeit not specific, which should, together with a positive serologic test, confirm the diagnosis.

Kaposi's sarcoma confined to the colorectum: a case report.

Reported is a new case of a Kaposi's sarcoma involving only the colorectal area in an HIV-negative patient presenting with hemorrhagic rectocolitis. The colonoscopic examination and the radiological imaging showed the presence of multiple nodular pseudopolypoid formations in the rectum, which suggested, in the differential diagnosis, primarily a malignant non-Hodgkin lymphoma.