[Association of streptococcal spondylitis and endocarditis. 2 new cases]. / Association de spondylodiscite à streptocoque et d'endocardite. Deux nouvelles observations.

Two new cases of spondylitis associated with endocarditis are reported. Approximately 30 cases have already been published in the medical literature. Although this association is infrequent, the possibility of its occurrence calls for repeated auscultation in patients with spondylitis and focal roentgenograms in patient with bacterial endocarditis who develop vertebral pain.

[The electrophysiologic effects of intravenously administered bepridil]. / Etude des effets électrophysiologiques du bépridil utilisé par voie veineuse.

The electrophysiological effects of intravenous bepridil were studied at doses of 2 mg/kg and 3 mg/kg. The drug was tested on 25 patients of both sexes who were undergoing electrophysiological investigation for other reasons (11 normal ECGs, 11 pathological ECGs, 3 WPW syndromes). Electrophysiological parameters before and after bepridil were compared. The following changes were noted: - the refractory period was significantly prolonged at all conducting levels; - the sinus cycle was significantly lengthened in a practically constant fashion (+9,2 p. 100); - conduction in the sinoatrial and atrioventricular nodes was significantly prolonged (+15 p. 100 and + 11 p. 100); - the Luciani-Wenckebach point was significantly decreased in the anterograde, and even more so in the retrograde, directions (-20 and -23 p. 100 respectively); - however, infrahisian conduction was not affected either in patients with normal or pathological ECGs. The drug was effective in blocking the accessory pathway in two of the three patients with the WPW syndrome. A study of drug plasma levels did not show a dose-effect relationship. The plasma levels were extremely variable from one subject to another, suggesting tissue fixation of the active part of the molecule. These results demonstrate the valuable electrophysiological effects of bepridil which, by its mode of action, is very similar to amiodarone.

[Clinicopathological study of the causes of mortality during the acute phase of myocardial infarction (author's transl)]. / Infarctus du myocarde. Etude anatomo-clinique des causes de la mortalité à la phase aiguë. 100 malades.

Clinical and autopsy study of 100 cases of patients dying during the first 3 weeks of hospitalisation for myocardial infarction revealed the following causes of death: cardiac failure in 59 cases (including 40 of cardiogenic shock), rupture of the heart in 29 cases (24 of rupture of the ventricular wall, 4 of the septum and 1 of a mitral papillary muscle). 4 ventricular arrhythmias and 6 haemorrhagic or embolic complications. In 2 cases, the cause of death could not be accurately determined. In cardiogenic shock, death usually occurred early. It was later in cases of refractory left ventricular failure. Conduction disturbances were much commoner in cases of myocardial infarction complicated by fatal cardiac failure (57.6%) than in the presence of any other complication (17.1%) (p less than 0.001). The responsible infarction was often extensive and recurrent. Rupture of the heart invariably occurred during the first three days of an infarction often initial (p less than 0.001), anterior (apart from septal rupture) and small in size (p less than 0.01). Other complications play only a secondary role in mortality at the present time, in particular arrhythmias, the gravity of which has greatly decreased since the reduction of delays before hospitalisation and improvements in anti-arrhythmic therapy.