[Old age and joint disease]. / Viellesse et maladies articulaires.

The seriousness of articular diseases in old persons is related to the loss of function and the rapid way this can lead to them being bed ridden. Rheumatoid polyarthritis is often difficult to distinguish from rhizomelic pseudopolyarthritis, these two diseases resemble each other at this age with the asthenia and loss of general health, the inflammatory pains which are peripheral and of nerve root origin. Among the metabolic arthropathies, articular chondrocalcinosis is frequent, and often latent, but sometimes it is destructive in particular in the hips and knees; septic arthritis today mainly occurs in the elderly, and the algoneurodystrophies are more frequent in old persons than in young subjects, following trauma or a hemiplegia. Arthrosis is obviously the main articular disease of senescence especially involving the joints of the lower limb, hip disease being less incapacitating than knee disease where surgical treatment is less often considered. The arthroses of the upper limbs especially of the shoulder are well tolerated. Osteochondromatosis, osteonecrosis of the internal condyle of the knee, the rapidly destructive arthropathies and hemarthrosis can develop as a complication of a simple arthrosis. In the spine vertebral hyperostosis is especially a disease of the elderly, it can occur alone or with an arthrosis of the posterior vertebral joints, a narrow spinal canal straight or narrowed. Medical treatment, physiotherapy, and finally surgery can give very satisfactory results in an old patient, avoiding loss of function, a miserable existence and becoming bed ridden.

Perceived efficacy of cyclandelate in the treatment of cochleovestibular and retinal disturbances related to cerebrovascular insufficiency. A study in general practice comprising 2772 patients.

To investigate the perceived efficacy and safety of cyclandelate when used in general practice, an open multicentre study was performed comprising 2772 patients with symptoms of vertigo, tinnitus or visual disturbances thought to result from cerebrovascular insufficiency. After 90 days' treatment with cyclandelate 1600 mg daily in 2 doses, both the severity and frequency of these symptoms declined. The general practitioners rated the overall therapeutic efficacy of cyclandelate as 'excellent' or 'good' in 81% of patients, while 77% of patients considered the efficacy of the drug to be 'excellent' or 'good'. Side effects were infrequent and of a mild nature. Thus, when used in the setting of general practice, cyclandelate seems to be a safe and apparently effective treatment for patients with symptoms of vertigo, tinnitus and visual disturbances attributable to chronic cerebrovascular insufficiency.

[Effects of 5023 SE on PaO2 at rest in elderly patients with cerebral impairment. A double-blind cross-over trial versus placebo]. / Effets du 5023 SE sur la PaCO2 de repos chez des sujets âgés insuffisants cérébraux. Essai croisé à double insu contre placebo.

In a double-blind cross-over study, the effects of Duxil on blood gases at rest were compared to those of a placebo in 39 elderly patients (mean age: 74.8 years). The study lasted 6 months divided into two 3-month periods. A mean increase of 2.10 mmHg in PaO2 was observed in patients under Duxil, the difference with the results obtained under placebo being statistically significant (p less than 0.01). At that dosage level, Duxil may therefore be considered an active treatment of hypoxia associated with old age.

[Anatomic incidence of meniscochondrocalcinosis of the knee]. / Fréquence anatomique de la ménisco-chondrocalcinose du genou.

The authors have studied the incidence of menisco-calcinosis (MC) and that of menisco-chondrocalcinosis (MCC) of knee joints of 108 non selected cadavera. The mean age of the subjects was 71.8 +/- 13.8 years. The study was performed by radiographic examination of the menisci and cartilagineous fragments of femoral condyles using high contrast films. The incidence of MC or MCC was found to be 18.5 per cent. It was slightly higher in females (21.5 p. cent) than in males (15.8 p. cent) subjects but this difference failed to reach the level of statistical significance. No positive case was detected before the age of 60 years. For the age groups of: 60-69, 70-79, 80-89 and over 90 years, its incidence was: 11.7; 26.9; 21.2 and 50 (4 subjects out of 8) per cent respectively. Approximately 40 per cent of all positive cases had meniscocalcinosis without associated chondrocalcinosis. No single case of chondrocalcinosis without meniscocalcinosis was observed. Six out of 8 cases with MC calcinosis and 2 out of 12 cases with MCC were unilateral. The external menisci were more frequently and more heavily affected than internal ones. Eighty per cent of the knees affected by either MC or MCC were at the same time associated to an osteoarthrotic lesion compared to 35 p. cent of the knees without MC or MCC matched for age: a result which appeared to be highly significant difference.

Arterial compliance, systolic pressure and heart rate in elderly women at rest and on exercise.

In two groups of elderly women, the relationships between arterial compliance estimated by pulse wave velocity (PWV), and systolic blood pressure (SP), heart rate (HR), oxygen consumption and the time taken to run 400 m have been studies. Both at rest and with increasing levels of exercise, faster PWVs are associated with higher SPs. These is a tendency for resting HR to be higher with faster PWVs. The changes in HR and oxygen consumption from resting values are strikingly increased with faster PWVs. The time taken over 400 m rises as arterial compliance falls. Therefore, it seems that, with aging, reduced arterial compliance is a major factor affecting cardiovascular responses to exercise.

[Osseous manifestations of treponematoses : six cases in immigrated black African (author's transl)]. / Manifestations osseuses des tréponématoses chez l'Africain de l'ouest immigré. A propos de six cas.

The authors report the cases of six immigrated Black Africans with clinical and radiological (4 cases with condensing osteitis ; 2 cases with condensing forms and multiple lacunae) bone manifestations ; these manifestations, the serological tests and the osseous biopsy (three cases out of four) are consistent with the diagnosis of bone syphilis. These facts are discussed and ascribed to tertiary syphilis rather than to congenital or secondary syphilis, to yaws or endemic syphilis.

[Two cases of tuberculosis of the skull cap (author's transl)]. / L'ostéite tuberculeuse de la voûte crânienne.

The authors report two cases of tuberculosis of the skull cap. The first in a Black African with heterozygous sickle cell disease also presenting with: tuberculosis of the cervical lymph nodes, subcutaneous frontal tumefactions bacteriologically confirmed to be of tuberculous origin, multiple lacunae of the vault from the same origin; the second case is an Asian woman having a multifocal tuberculous osteitis involving the skull, spine, pelvis and probably the same affection in the spleen. These cases are a reminder that the principal features of tuberculosis of the skull vault are very often associated with other tuberculous lesions, and to the problems of diagnosis it entails; the existence of a subcutaneous tumefaction of the vault or of any accessible site one can aspirate and/or perform biopsy constitutes a diagnostic aid.

[Articular chondrocalcinosis after 80 years of age]. / La chondrocalcinose articulaire après 80 ans.

In 108 women over 80 (mean age 88,4 years, extremes 80 and 99 years) hospitalized in a geriatric service for various reasons, radiograms were made of both knees in the frontal aspect on standard film to detect calcinosis of the meniscus and chondrocalcinosis of the joint. In 25 women (23.1%) the radiographs revealed calcinosis of the meniscus with or without chondrocalcinosis. In these 25 cases a lateral X-ray was also made of the two knees, frontal X-rays were made of the pelvis, thumbs and shoulders. In 22 cases (88%) these revealed calcification of the fibrocartilages or articular cartilages in joints other than the knee. Seven of the 25 women had at least one attack of articular inflammation (especially of the knee) resembling a pseudo-gout crisis. The frequency of chronic arthropathies resembling arthroses was high in the 25 patients with chondrocalcinosis: 8 (32%) had an internal or external femoro-tibial arthrosis, as against 11 of the 83 patients (13%) of the same age without chondrocalcinosis, a significant difference. Eleven of the 25 women had signs of femororotular arthrosis on the lateral X-rays of the knees, 5 had coxarthrosis (with in 3 cases a radiological image of fibrocartilaginous or coxofemoral cartilaginous calcification). One women had chronic radiocarpal arthropathy evocative or chondrocalcinosis. Ten had a scaphotrapezoidal arthrosis, 5 arthrosis of the shoulder, 3 with radiological aspect of glenohumeral chondrocalcinosis.