Objective and subjective sleep disturbances in patients with rheumatoid arthritis. A reappraisal.

OBJECTIVE: To assess objective and subjective evidence of sleep disturbances in patients with rheumatoid arthritis (RA) and to examine correlations between parameters of inflammatory activity and sleep pathology. METHODS: Nineteen RA patients and 19 age-matched healthy control subjects underwent all-night polysomnography on 2 consecutive nights. RA patients were also evaluated for daytime sleepiness by mean sleep latency test and responded to a self-report questionnaire on their first night. RESULTS: Whereas normal sleep architecture is conserved in RA, we confirmed former findings of severe sleep fragmentation and an enhanced presence of primary sleep disorders. No correlation exists between RA activity and the sleep disorders. Subjective assessment was not consistent with the objective evidence of sleep disruption, unlike the findings in patients with fibrositis. CONCLUSION: Sleep is severely disturbed in patients with RA, regardless of the inflammatory disease activity. The specificity of the sleep disorders assessed needs confirmation, as does specific sleep therapy for these patients.

[Meshed graft fixation with synthetic glue (Nobecutan) in pediatrics]. / Fijación de injertos mallados con adhesivo sintético (Nobecutan) en pediatría.

Burns in children carry many age-related problems. Maintenance of immobility and cleanness of absorbent dressings are very difficult, especially in infancy and large wounds. These problems are very important when meshed skin grafts are used. Graft survival is disturbed by patient movements and septic colonization, especially in the early postoperative period. Over a two years period we have been applying Nobecutan as meshed skin graft fixation procedure, antiseptic and protecting wound coat. The use of Nobecutan is a time-saving technique. No sutures nor staples are employed, which is very important when working with burned children. No local adverse effects, nor prolongation of wound healing had been observed.

[A world record in marathon tennis: sleep deprivation and performance]. / Record du monde du marathon de tennis: privation de sommeil et performances.

We studied the effects of marked sleep deprivation on the EEG patterns and performance of a physically fit man (age 26) on the occasion of the world record continuous marathon tennis play (147 hours, 20 minutes). Before and immediately after the marathon, the sleep patterns of the player were recorded in our laboratory. After playing for 40 and 80 hours and within 24 hours, the performance changes were evaluated each hour. Amounts of the different sleep stages during the first recovery night compared with those of the baseline indicate an increase of 56% for total sleep time, 54% for stages 1 and 2, 154% for stages 3 and 4 and 20% for REM sleep. During the second recovery night, only REM sleep showed an increase. Activity index showed a marked decrease after 80 hours of sleep deprivation compared with that after 40 hours and was dramatically worsened during nighttime. The number of faults and pauses was also increased after 80 hours, suggesting a clear performance deterioration. Our results confirmed the effects of sleep deprivation on the recovery and performance deterioration.

[Comparative study of ultrasonography and scintigraphy in liver metastases detection (author's transl)]. / Etude comparative de l'échographie et de la scintigraphie dans la détection des métastases hépatiques.

The sensitivity and specificity of ultrasonography and scintigraphy for detecting the presence of liver metastases were compared in 250 patients with cancer. In the 80 cases with metastases, the sensitivity of ultrasonography was 95%, that of scintigraphy being 75%. In 170 cases without metastases the specificity of ultrasonography was 96%, that of scintigraphy being 92%. These results, confirmed by reports in the published literature, show that ultrasonography should be the first morphological-detecting examination for suspected hepatic metastases, with scintigraphy as a second option.

[Demonstration of tumour temperature variation during curietherapy for cancer of the uterine cervix (author's transl)]. / Mise en évidence d'une variation de température tumorale au cours d'une curiethérapie pour cancer du col de l'utérus.

We here describe a simple apparatus for measuring temperature, accurate to 3/100 of a degree, which makes it possible to follow variations in the temperature of an accessible internal organ, and we also describe its application to the observation of possible changes in the temperature of a tumour of the uterine cervix, during treatment by curietherapy.