[Impact of a public-directed media campaign on emergency call to a mobile intensive care units center for acute chest pain]. / Intérêt d'une campagne d'information régionale sur les urgences cardiaques et l'appel au 15.

Cardiovascular diseases represent the second highest cause of mortality among the 25-65 age group in the Nord-Pas-de-Calais region. The Monica study clearly showed that in 1996 the average length of time between a casualty showing the first signs of a coronary and the commencement of treatment was 3 h 30 in northern region of France compared with an average of 2 hours for the rest of the country. Many factors play a part: lack of knowledge of the symptoms, ignorance of the benefits of making an early call to the ambulance, lack of awareness of the french emergency services- centre 15 and its role, absence of any structured network for coronary emergencies. Given these observations, an extensive regional informative campaign is being launched for the first time in France, which will involve all relevant health professionals. The 2 aims of this campaign are to encourage people to call centre 15 directly and as quickly as possible after noticing the first coronary symptoms, and to encourage general practitioners (GPs) to "prescribe calling centre 15". The impact of this campaign has been estimated using the descriptive analysis of the relationship between the number of calls made to centre 15 by the general public and doctors and the number of successful prehospital interventions by the mobile emergency unit of Lille in cases of coronaries and thrombosis. The results of 3 telephone surveys of 1200 people carried out by the emergency services and 2 surveys carried out by a private company were also used for this evaluation. The analysis of this data provides a wealth of arguments in favour of the effectiveness of the campaign. On one hand this is due to the quality of its contents, which we compared to a similar campaign and on the other hand it is due to its lengthy duration.

Paroxysmal kinesigenic choreoathetosis: a report of 26 patients.

Paroxysmal kinesigenic choreoathetosis (PKC) is a neurological condition which results in abnormal involuntary movements that are precipitated by sudden movement. Because of its rarity, large case series of PKC have not been published. We studied 26 patients with PKC, which represents the largest series thus reported. We reviewed our cases with respect to attack characteristics, aetiology, family history, and treatment response. Our population consisted of 23 men and 3 women. Seven patients had a family history of paroxysmal dyskinesia. None of our patients had clear evidence of symptomatic PKC. Two-thirds of our patients had attacks lasting between 30-60 s, and over one-half experienced one to ten attacks per day. Attack distribution varied widely, and most experienced pure dystonia rather than choreodystonic movements. Most patients responded very well to anticonvulsant therapy. We also report the PET results from two of our patients and Bereitschaftspotential abnormalities recorded from two others.

Paroxysmal exercise-induced dystonia: eight new sporadic cases and a review of the literature.

We report eight new sporadic cases of paroxysmal dystonia induced by prolonged or sustained exercise and review an additional seven previously reported cases. The attacks in our patients lasted from a few minutes to up to 2 h, and patient age at onset ranged from 2 to 30 years. Four of the eight patients had hemidystonic attacks, both legs were involved in two other cases, and the remaining two patients had involvement of the right foot only. We propose that such cases should be classified as paroxysmal exercise-induced dystonia.

Focal task-specific tremors.

Focal task-specific tremors besides primary writing tremor have rarely been reported in the literature. We describe nine cases of focal tremors induced by different specific tasks, involving a repetitive and frequently performed movement. Only one of these patients had a family history of any similar disorders. There was no overt dystonia in any of the cases, but these tremors may be forms of focal dystonia, rather than a manifestation of essential tremor.

Sex prevalence of focal dystonias.

The sex prevalence of idiopathic focal dystonia is reported from a data base review of all patients seen at the National Hospital of Neurology, Queen Square and King's College, London up to 1993. There was a higher prevalence of females to males in all categories of focal dystonia involving the craniocervical region. The female to male ratio for cranial dystonia was 1.92:1 (P < 0.01) and 1.6:1 (P < 0.001) for spasmodic torticollis. On the other hand, twice as many men than women had writer's cramp (M:F = 2.0:1, P < 0.01). At present, there is no clear explanation to account for this differences in the sex prevalence of different types of focal dystonia.

Effect of airway wall flexibility on clearance by simulated cough.

In our previous study, we investigated the relationship between mucus rheology, depth of mucus layer, and clearance by simulated cough. The purpose of the present study was to examine the effect of airway wall flexibility on the clearance of mucuslike gels. Transient airflows similar to cough were generated by both positive and negative pressure, the latter to mimic the dynamic compression that occurs during real cough. As in the previous study, the trachea was modeled as a trough of rectangular cross section with only the bottom lined with the mucus simulant. Clearance was followed by observing the displacement of marker particles. Since cough clearance is intimately related to wave formation in the mucus blanket, we hypothesized that clearance might be impeded if the wave formation occurred simultaneously in the wall and its lining layer. Thus, in one set of experiments the bottom rigid surface of the model trachea was replaced with a frame over which a flexible membrane could be drawn, whereas in the other set the rigid top was replaced by the frame. We also examined the effect of negative-pressure cough in excised canine tracheae, comparing the case where the tracheal membrane was free to deform vs. the case where it was secured. For the rigid-walled model, clearance by positive or negative pressure, with matched flow pattern, was the same. With the mucus simulant lining the flexible bottom surface, clearance increased with increasing membrane flexibility for negative-pressure cough and decreased for positive-pressure cough.(ABSTRACT TRUNCATED AT 250 WORDS)