[Modes of administration of beta agonists in asthma]. / Modes d'administration des bêta agonistes dans l'asthme.

Short-acting beta 2 agonists have a rapid and potent bronchodilating effect and represent the basis of treatment of acute asthma. Whatever the level of severity, the inhaled route is preferred because of its high efficacy/tolerance ratio. The doses and modes of administration depend on the severity of the airway obstruction, the site of management and the available devices. Long-acting beta 2 agonists are administered as regular treatment in moderately-severe to severe chaonic asthma in association to inhaled corticosteroids, mainly by the inhaled route whereas the oral route may be considered for the administration of prodrugs.

Gadolinium-enhanced MRI in cerebral Whipple's disease.

Confusion developed in a 44-year-old man, who had diarrhoea and weight loss for three months. Jejunal biopsy showed infiltration by PAS-positive macrophages, indicating Whipple's disease. Cranial MRI disclosed multiple lesions mainly in the white matter and grey-white matter junction better demonstrated after gadolinium injection.

Multifocal central nervous system lesions in three patients with trichinosis.

Three patients with trichinosis developed central nervous system complications. Cerebral computed tomography showed multifocal hypodense lesions in two patients. The lesions were associated with contrast enhancement and cortical gyral enhancement in the first case, suggesting hypoxia and infarction. In the second patient, magnetic resonance imaging showed multiple high-signal-intensity lesions. Early cerebral computed tomography was normal in the third patient. All patients recovered after treatment with antiparasitic drugs and corticosteroids. We suggest that neurologic complications of trichinosis should be treated by corticosteroids and flubendazole.

[Chronic osteitis and arthritis of palmoplantar pustulosis. A familial form of B-27 negative spondylarthropathy]. / Les ostéites et arthrites chroniques de la pustulose palmo-plantaire. Une forme familiale de spondylarthropathie B27 négative.

A 35-year old woman presented with pustulosis palmaris et plantaris evolving in acute episodes parallel to those of a rheumatic disease consisting of bilateral sacro-iliac arthritis, manubriosternal fusion and sterno-clavicular arthritis. Her brother had spondylitis compatible with the diagnosis of pustular osteo-arthritis though without pustulosis. He presented with bilateral sacro-iliac arthritis, manubriosternal fusion, sterno-clavicular arthritis and an ossified fragment detached from the antero-inferior angle of C6. The two patients had the same HLA phenotype: A1, A9, B5, B41, CW4, DR2, DR4, absence of B27. In a specimen from the sacro-iliac joint the authors found active bone remodelling and inflammatory osteitis with fibrosis and infiltrates rich in mononucleate cells. An electron microscopic study--to the authors' knowledge, the first to be performed in such cases--demonstrated intracytoplasmic filamentous inclusions in two macrophages of the synovial fringe. Only one other case of the familial form has been published so far. Like the rheumatism of acne conglobata, the spondylitis of pustulosis palmaris et plantaris is one of the causes of sterno-costo-clavicular hyperostosis.

[Characteristics of benzodiazepine consumption in patients hospitalized in an internal medicine department]. / Caractéristiques de la consommation de benzodiazépines chez des patients hospitalisés dans un service de médècine interne.

We have studied benzodiazepines (BZD) intake among 129 patients admitted in an internal medicine unit. In this population, we have differentiated long term (over 4 months) users (n = 25), occasional users (n = 24), and non users (n = 80). Analysis of the results favoured the fact that BZD users were, more than non users, alike to have a history of cardiovascular and/or rheumatic diseases, to have had multiple surgical procedures and that these patients often took several other psychotropic and non psychotropic drugs. Particular characteristics of long term users are discussed next (prevalence, sex ratio, incidence of depression).

Isolation of human T-lymphotropic retrovirus (LAV) from Zairian married couple, one with AIDS, one with prodromes.

A Zairian married couple had been living in France since 1981. The man had acquired immunodeficiency syndrome (AIDS) and his wife had prodromes of the disorder. Infection with a human T-lymphotropic retrovirus (lymphadenopathy-associated virus) was demonstrated in both by isolation of the virus from their cultured lymphocytes and the detection of specific antibodies in serum samples. Since this virus has been isolated from patients in other AIDS risk categories, the finding of the virus in AIDS patients from the African group adds further support to the hypothesis that this human retrovirus is the AIDS aetiological agent.

[Sterno-chondro-costal joint arthritis in heroin addicts. Value of computed x-ray tomography. 4 cases]. / L'arthrite sterno-chondro-costale de l'héroïnomane. Intérêt de l'examen tomodensitométrique. Quatre observations.

Four cases of sterno-articular arthritis in young heroin addicts are reported. The diagnosis, much facilitated by the knowledge of drug addiction, is confirmed by biopsy which excludes a tumour, usually malignant in that region. Computerized tomography is essential to explore for retrosternal extension. In the absence of extension cure can be obtained by medical treatment, thus avoiding resection of the sternum and rib with subsequent plastic surgery.

[Echocardiographic measurement of true left ventricular inotropism in patients under haemodialysis (author's transl)]. / Mesure de l'inotropisme réel du ventricule gauche de l'hémodialysé chronique par échocardiographie Tm.

M-mode echocardiography was performed 18 to 22 hours after a haemodialysis session in 16 patients under chronic dialysis. The patients (12 men and 4 women, mean age 21 years, haematocrit 24 +/- 5%) were normotensive and had no clinical or radiological sign of heart failure. Patients with renal hypertension, diabetes or amyloidosis had been excluded from the study. Eight healthy subjects of similar age, heart rate and blood pressure were used as controls. In all 24 individuals the following parameters were calculated: end diastolic time diameter index (DTDI), end systolic time diameter index (STDI), ejection time (ET), mean velocity of circumferential fiber shortening (VCF) and ejection fraction (EF). DTDI was greater in haemodialyzed patients (31 +/- 2 mm/m2) than in controls, but STDI and ET were the same in both groups. This would explain the increase of VCF (1.68 +/- 0.1 c/sec) and EF (0.78 +/- 0.05) observed in dialyzed patients. After compression of the fistula for 3 min the differences disappeared. These results suggest that the echocardiographic measurements listed above give a better idea of the true contractile state of the left ventricle in haemodialyzed patients, disregarding load changes due to the fistula, to anaemia and to intermittent volume expansion.