[Tuberculous reactions]. / Réactions tuberculiniques.

Intradermoreaction made with reliable tuberculin is the reference test: it is the only one that allows a therapeutic decision. The other tests can only be used as pre or post vaccinal tests, or as a technical approach for new born. In France, the reading of the IDR is difficult because BCG is almost always applied during small childhood. However it is possible to admit tuberculosis infection for vaccinated person with clear increase of the IDR positivity compared to a measured reference IDR, or when the IDR is superior to 14 mm for persons vaccinated a long time ago. For immunocompetent persons, a tuberculosis infection admitted on an isolated IDR (not associated with tuberculosis disease) does not need chimiprophylaxy for children under five, or in case of clear and recent increase of IDR, or in a context of contamination. For a HIV positive person, a tuberculosis infection admitted on an isolated IDR implies a systematic chimioprophylaxy, but the IDR looses its signification as the immunodepression progresses. An attempt to study the prevalence of tuberculosis infection at twenty in France for vaccinated persons has been realized. In 1984 the admitted rate is over 8%, superior to the calculated rate from Styblo and Sutherland tables. That seems to mean that tuberculosis infection is under evaluated in France.

[Malignant thymoma and paroxystal peripheral disease, a case report (author's transl)]. / Thymome malin et acrosyndromes vasculaires paroxystiques: une observation.

Report in a 68 years old man of the association of erythermalgia and malignant thymoma. Improvement of erythermalgia after resection of the thymoma is demonstrative of paraneoplasic syndrome. Tumoral secretion of serotonine is suggested by ultrastructural features of the tumour and increasement of urinary 5 HIAA.

[Long-term administration of calcium-heparin in thromboembolism (author's transl)]. / Traitement au long cours de la maladie thrombo-embolique par l'héparinate de calcium.

The profound importance of thrombosis in natural history of venous and arterial thromboembolism justifies long-term use of heparin, the best antithrombotic agent. Through the study of 88 cases concerning patients treated by subcutaneous calcium-heparin for a time from 3 months to 6 years, in several indications of venous and arterial thromboembolism, we can bring the following results: - The treatment is easily accepted when patients are inquired and trained. The doses must be adapted according to clotting assays, which do no more restrain patients than during oral anticoagulant treatment. - The frequency of hemorrhagic complications is the same than during antivitamine K treatments. - Thrombosis occur rarely during heparin therapy, but with high frequency during oral anticoagulant treatments. - Osteoporosis is a real but acceptable risk (10 p. cent) of long-term heparin prescription. - The true limit of treatment is the frequency (34 p. cent) of cutaneous hypersensibility reactions with high blood eosinophilia rate. Always mild, this reaction is related to the subcutaneous administration, and heparin is likely not the single impeached substance. These undesirable effects bind us to their thorough study, in order to obtain better tolerated drugs.