Evolution of pigments and their relationship with skin color and sensory profile in date fruits (Phoenix dactylifera L.).

Fresh dates of seventeen varieties and khalts from Southern Morocco were analysed for their colour, pigments content, and sensory profile. The results showed significant differences between the sensory profiles of the samples due to the variability of the genotype and their different origin. Fresh date varieties and khalts were a good source of ß-carotene (0.49 - 10.86 µg of ß-carotene /100 g FW). The results revealed that the date varieties and khalts were found to have an excellent functional composition and good sensory characteristics. Therefore, these varieties of Moroccan dates could be used for fresh consumption and in the processing industry, which will constitute a significant source of antioxidants.

Date seeds (Phoenix Dactylifera L.) valorization: chemical composition of lipid fraction.

This research was aimed to study the lipid fraction of date seeds. Seventeen seeds of date palm varieties and clones were evaluated and assessed for their chemical components and for the properties of the date pits oil. Gas liquid chromatography showed that the main unsaturated fatty acid was oleic acid (46.00 - 50.87%), while the main saturated fatty acid was lauric acid (10.11 - 19.03%) for the cultivars Mentouj Tissgharine (MTN) and Bheir Ingli (KBN) respectively; other fatty acids were also identified. The physicochemical characterization showed an acid value ranging from 0.068 to 1.188%, a specific extinction value equal to (K232: 1.350-2.225; K270: 0.318- 0.521), a peroxide value in the interval (1.059-5.618 meq O2/kg) and an iodine value (41.861-59.980 g Iodine/100 g). The pheophytin content of date seed oils was found within the range from 21.855 to 75.685%. The chemical analysis showed that date seed oil can be useful in cosmetic and food products processing.

Evaluation of some nutritional quality criteria of seventeen Moroccan dates varieties and clones, fruits of date palm (Phoenix dactylifera L.).

Date fruit is known to be the staple food in the Arab countries. It provides a lot of potential health benefits and can be the essential source of nutrients. The majority of Moroccan varieties are not characterized for their chemical, biochemical and quality properties. The aim of this work was to assess the chemical composition of 17 varieties of Moroccan date fruits (Phoenix dactylifera L.) and to determine their nutritive components. The analysis showed that the dates are rich in sugars (51.80-87.98%), they contain low concentration of proteins (1.09-2.80%) and lipids (0.16-0.39%). The predominant mineral is potassium (1055.26-1604.10 mg/100 g DW). Moreover, they contain high concentrations of malic acid (69.48-495.58 mg/100 g (DW)), oxalic acid (18.47-233.35 mg/100 g DW) and tartaric acid (115.70-484.168 mg/100 g DW). These results suggest that the date fruit are nutritious and can be an excellent source for human nutrition and health benefits.

Evaluation of some nutritional quality criteria of seventeen Moroccan dates varieties and clones, fruits of date palm (Phoenix dactylifera L) / Avaliação de alguns critérios de qualidade nutricional de 17 variedades e clones marroquinos de datas, frutos de tamareira (Phoenix dactylifera L)

Date fruit is known to be the staple food in the Arab countries. It provides a lot of potential health benefits and can be the essential source of nutrients. The majority of Moroccan varieties are not characterized for their chemical, biochemical and quality properties. The aim of this work was to assess the chemical composition of 17 varieties of Moroccan date fruits (Phoenix dactylifera L.) and to determine their nutritive components. The analysis showed that the dates are rich in sugars (51.80-87.98%), they contain low concentration of proteins (1.09-2.80%) and lipids (0.16-0.39%). The predominant mineral is potassium (1055.26-1604.10 mg/100 g DW). Moreover, they contain high concentrations of malic acid (69.48-495.58 mg/100 g (DW)), oxalic acid (18.47-233.35 mg/100 g DW) and tartaric acid (115.70-484.168 mg/100 g DW). These results suggest that the date fruit are nutritious and can be an excellent source for human nutrition and health benefits.

A fruta da tâmara é conhecida por ser o alimento básico nos países árabes. Oferece muitos benefícios potenciais à saúde e pode ser a fonte essencial de nutrientes. A maioria das variedades marroquinas não se caracteriza por suas propriedades químicas, bioquímicas nem de qualidade. O objetivo deste trabalho foi avaliar a composição química de 17 variedades de frutos de tâmara marroquina (Phoenix dactylifera L.) e determinar seu valor nutritivo. A análise mostrou que as tâmaras são ricas em açúcares (51,80-87,98%) e contêm baixa concentração de proteínas (1,09-2,80%) e lipídios (0,16-0,39%). O mineral predominante é o potássio (1.055,26-1.604,10 mg/100 g DW). Além disso, contêm altas concentrações de ácido málico (69,48-495,58 mg/100 g DW), ácido oxálico (18,47-233,35 mg/100 g DW) e ácido tartárico (115,70-484,168 mg/100 g DW). Esses resultados sugerem que o fruto da tamareira é nutritivo e pode ser uma excelente fonte de nutrição humana e conferir benefícios à saúde.

Evaluation of some nutritional quality criteria of seventeen Moroccan dates varieties and clones, fruits of date palm (Phoenix dactylifera L.)

Abstract Date fruit is known to be the staple food in the Arab countries. It provides a lot of potential health benefits and can be the essential source of nutrients. The majority of Moroccan varieties are not characterized for their chemical, biochemical and quality properties. The aim of this work was to assess the chemical composition of 17 varieties of Moroccan date fruits (Phoenix dactylifera L.) and to determine their nutritive components. The analysis showed that the dates are rich in sugars (51.80-87.98%), they contain low concentration of proteins (1.09-2.80%) and lipids (0.16-0.39%). The predominant mineral is potassium (1055.26-1604.10 mg/100 g DW). Moreover, they contain high concentrations of malic acid (69.48-495.58 mg/100 g (DW)), oxalic acid (18.47-233.35 mg/100 g DW) and tartaric acid (115.70-484.168 mg/100 g DW). These results suggest that the date fruit are nutritious and can be an excellent source for human nutrition and health benefits.

Resumo A fruta da tâmara é conhecida por ser o alimento básico nos países árabes. Oferece muitos benefícios potenciais à saúde e pode ser a fonte essencial de nutrientes. A maioria das variedades marroquinas não se caracteriza por suas propriedades químicas, bioquímicas nem de qualidade. O objetivo deste trabalho foi avaliar a composição química de 17 variedades de frutos de tâmara marroquina (Phoenix dactylifera L.) e determinar seu valor nutritivo. A análise mostrou que as tâmaras são ricas em açúcares (51,80-87,98%) e contêm baixa concentração de proteínas (1,09-2,80%) e lipídios (0,16-0,39%). O mineral predominante é o potássio (1.055,26-1.604,10 mg/100 g DW). Além disso, contêm altas concentrações de ácido málico (69,48-495,58 mg/100 g DW), ácido oxálico (18,47-233,35 mg/100 g DW) e ácido tartárico (115,70-484,168 mg/100 g DW). Esses resultados sugerem que o fruto da tamareira é nutritivo e pode ser uma excelente fonte de nutrição humana e conferir benefícios à saúde.

Evaluation of some nutritional quality criteria of seventeen Moroccan dates varieties and clones, fruits of date palm (Phoenix dactylifera L. ) / Avaliação de alguns critérios de qualidade nutricional de 17 variedades e clones marroquinos de datas, frutos de tamareira (Phoenix dactylifera L. )

Date fruit is known to be the staple food in the Arab countries. It provides a lot of potential health benefits and can be the essential source of nutrients. The majority of Moroccan varieties are not characterized for their chemical, biochemical and quality properties. The aim of this work was to assess the chemical composition of 17 varieties of Moroccan date fruits (Phoenix dactylifera L.) and to determine their nutritive components. The analysis showed that the dates are rich in sugars (51.80-87.98%), they contain low concentration of proteins (1.09-2.80%) and lipids (0.16-0.39%). The predominant mineral is potassium (1055.26-1604.10 mg/100 g DW). Moreover, they contain high concentrations of malic acid (69.48-495.58 mg/100 g (DW)), oxalic acid (18.47-233.35 mg/100 g DW) and tartaric acid (115.70-484.168 mg/100 g DW). These results suggest that the date fruit are nutritious and can be an excellent source for human nutrition and health benefits.

A fruta da tâmara é conhecida por ser o alimento básico nos países árabes. Oferece muitos benefícios potenciais à saúde e pode ser a fonte essencial de nutrientes. A maioria das variedades marroquinas não se caracteriza por suas propriedades químicas, bioquímicas nem de qualidade. O objetivo deste trabalho foi avaliar a composição química de 17 variedades de frutos de tâmara marroquina (Phoenix dactylifera L.) e determinar seu valor nutritivo. A análise mostrou que as tâmaras são ricas em açúcares (51,80-87,98%) e contêm baixa concentração de proteínas (1,09-2,80%) e lipídios (0,16-0,39%). O mineral predominante é o potássio (1.055,26-1.604,10 mg/100 g DW). Além disso, contêm altas concentrações de ácido málico (69,48-495,58 mg/100 g DW), ácido oxálico (18,47-233,35 mg/100 g DW) e ácido tartárico (115,70-484,168 mg/100 g DW). Esses resultados sugerem que o fruto da tamareira é nutritivo e pode ser uma excelente fonte de nutrição humana e conferir benefícios à saúde.

An overview of the rationale for pharmacological strategies in type 2 diabetes: from the evidence to new perspectives.

Therapeutic strategies in type 2 diabetic patients should not only integrate both the targets and indications of the different therapies but should be also a compromise between the patient's and physician's goals and willingnesses. The rationale for therapeutic targets is based on recommendations that differ from one country to another. Even though HbA1c remains the "gold standard", monitoring of blood glucose at fasting and postprandial time-points is a complementary tool for estimating both the quality and safety of diabetic control. Despite the lack of available strong evidence-based data it seems that achieving glucose levels < 130 mg/dl at fasting and < 180 mg/dl or < 140 mg/dl over postbreakfast or postlunch periods, respectively, might be a reasonable goal in most countries. The choice of appropriate strategies for treating type 2 diabetic patients should ideally be based on pathophysiological considerations. However for practical reasons, decisions for initiating or completing antidiabetic treatments are usually made by using such simple parameters as HbA1c and plasma glucose levels. The bridge between pathophysiological and clinical rationales can be obtained from the analysis of the relative contributions of fasting and postprandial glucose to the overall hyperglycaemia. In patients with HbA1c < 7.3%, postprandial glucose makes the major contribution to the overall hyperglycaemia, whereas the contribution of fasting glucose becomes progressively predominant in patients with HbA1c > 7.3%. As a consequence of these observations, initiation of antidiabetic treatments or implementation of second-line therapies should be aimed at reducing either postprandial excursions or fasting hyperglycaemia according to whether HbA1c levels are found respectively below or above a cut-off value of 7.3%.

Comparative efficacy and safety of enalapril and sustained-release nifedipine in patients with mild to moderate hypertension. The Enalapril vs Nifedipine French Study Group.

The long acting angiotensin-converting enzyme inhibitor enalapril was compared with the calcium channel blocker nifedipine as sustained-release formulation in 136 patients with mild to moderate hypertension. This multicentre study was carried out in a double-blind, double-dummy fashion by 28 cardiologists in private practice. After a 2-week placebo period, patients were randomly allocated to 2 treatment groups; the first group received enalapril 20 mg daily (n = 68), and the second group received sustained-release nifedipine 20 mg twice daily (n = 68). The duration of treatment was 12 weeks. In both groups, hydrochlorothiazide 25 mg was added at week 4 if diastolic blood pressure remained greater than 90 mm Hg. At week 8, if the target diastolic pressure of less than 90 mm Hg was not achieved, the dosage of hydrochlorothiazide was increased to 50mg. The clinical characteristics of the patients in each group were comparable. After 4 weeks of treatment, the reduction in supine diastolic blood pressure was similar in both groups (12.1 mm Hg in the enalapril group vs 10.3 mm Hg in the nifedipine group). Moreover, although the difference between the groups was more noticeable after 12 weeks of treatment (16.3 vs 13.9 mm Hg, respectively), it did not reach significance. The number of patients experiencing clinical adverse effects was significantly greater in the nifedipine group than in the enalapril group [33 (48.5%) vs 18 (26.5%), respectively]. The most common complaints of patients administered nifedipine included swollen ankles, flushing and headaches, whereas complaints in the enalapril group included cough, asthenia, and epigastralgia. Three patients were withdrawn from the study because of side effects in the enalapril group and 10 were withdrawn from the nifedipine group. These results indicate that enalapril and sustained-release nifedipine are equally effective in controlling mild to moderate hypertension. However, enalapril was much better tolerated in this study.

Serum neuron-specific enolase. A marker for disease extent and response to therapy for small-cell lung cancer.

Serum neuron-specific enolase (S-NSE) levels in 43 newly diagnosed untreated patients with small-cell lung cancer (SCLC) were compared with levels in 35 adult controls, 14 patients with non-small cell lung cancer (N-SCLC), and nine patients with noncancerous lung disease (N-CLD). The S-NSE level was raised (greater than or equal to 16 ng/ml) in 28 of 43 patients with SCLC, six of 16 patients with limited stage SCLC, and 22 of 27 of those with extensive stage SCLC. Extensive stage patients with SCLC had a significantly higher mean S-NSE level (50 ng/ml) than did limited stage patients with SCLC (16 ng/ml). Mean S-NSE levels in patients with N-SCLC and in patients with N-CLD were respectively 11 and 7 ng/ml. Serial measurements performed on 19 patients between the three-day-courses of chemotherapy showed an excellent correlation between S-NSE and clinical evolution. In addition, S-NSE was measured during the first three-day course of chemotherapy in 13 other patients; among them, seven had S-NSE levels greater than or equal to 100 ng/ml (mean: 490 ng/ml); these seven patients were responders; the remaining six had S-NSE levels less than 100 ng/ml (mean 28 ng/ml): among them, only two were responders. Such S-NSE measurements during the first cytostatic course seem to reflect the importance of tumor burden and may be valuable as early indicators of the response rate to chemotherapy.

Influence of tidal volume on histamine-induced bronchoconstriction in guinea pigs.

The effects of tidal volume amplitude on bronchopulmonary reactivity were investigated in three groups of 14 anesthetized paralyzed mechanically ventilated guinea pigs. Animals of group 1 served as control; in animals of group 2, both the sympathetic and parasympathetic nervous systems were blocked; in animals of group 3, only the parasympathetic system was blocked. In each group, the animals were randomly divided into two subgroups characterized by their ventilatory pattern: rate of 60/min with a 6-ml/kg tidal volume or rate of 40/min with a 9-ml/kg tidal volume. Bronchopulmonary reactivity to infused histamine was assessed by the respiratory compliance and conductance values measured during bronchoconstriction and expressed as a percentage of the corresponding basal values. In group 1 the animals ventilated with a 9-ml/kg tidal volume were found significantly less reactive than those ventilated with a 6-ml/kg tidal volume. This difference was abolished in groups 2 and 3. These results demonstrate that the effects of increased tidal volume on bronchopulmonary reactivity are vagally mediated and suggest that the decrease observed in histamine-induced bronchoconstriction is mainly due to reflex effects evoked by stretch receptor stimulation.

Influence of body temperature on histamine-induced bronchoconstriction in guinea pigs.

The effects of body temperature on histamine-induced bronchoconstriction were investigated in anesthetized, paralyzed, and mechanically ventilated guinea pigs. Four groups of guinea pigs were studied with constant body temperatures of 40, 38, 35, and 32 degrees C, respectively. Histamine was infused for 5 min at a rate of 50 ng.kg-1.s-1. Body cooling from 40 to 32 degrees C augmented the bronchomotor responses to histamine, which eventually rose almost fourfold. The enhancement of histamine-induced bronchoconstriction induced by body cooling was not suppressed by pretreating guinea pigs with 5 mg/kg hexamethonium or 5 mg/kg hexamethonium plus 3 mg/kg atropine; neither was the enhancement of histamine-induced bronchoconstriction suppressed in pithed guinea pigs, demonstrating that the autonomic nervous system is not involved in potentiating bronchoconstriction at low body temperatures. These results suggest that, at low body temperatures, increased airway responsiveness to histamine may be because of some direct effect of temperature on bronchial airway smooth muscle.

Computer added locomotion by implanted electrical stimulation in paraplegic patients (SUAW).

Paraplegia means a live long sentence of sensory loss, paralysis and dependence with approximately 1000 new victims in every European country every year and 11.500 new traumatic SCI cases in the US. respectively. Sixty percent are injured before age 30. More than 90% of SCI victims may survive with nearly normal experience of live. Most patients will recover somewhat from SCI over time but no patient who remained plegic for one year regains voluntary motor function after that time period. Despite remarkable efforts and recent achievements in rehabilitation no treatment can be recommended so far to enhance functional recovery and restoring locomotion in paraplegic humans. FES as a technical compensation has become therefore a challenging treatment to restore muscle function and to prevent atrophy and to improve mobility and quality of life at the same time. In paraplegics FES could be the basis to restore locomotion. One of the advantages of an implanted FES version (neuroprosthesis) is that the FES system, electrodes, and cables remain permanently implanted within the body, so that the patient can stay without cables, the programmer attached to the crutches. The SUAW project, supported under BIOMED II Programme by the European Community was aimed to finalize and to put into practice the results of previous research and development. The novel implant with an ASCI-Chip has 16 channels, 8 on each side, 20 mA for monopolar and 2 mA for bipolar stimulation, only one electrode can be stimulated at a given time. Stimulation of 6 muscle groups of both legs are known to be sufficient for locomotion: M. ileopsoas (erector of the body, hip flexor), M. gluteus maximus (hip extensor), M. gluteus medius (lateral hip stabilisator, knee abductor), Mm. hamstrings (knee flexor) stimulated by epimysial electrodes, Mm. sartorius and rectus femoris (knee extensor) stimulated by neural, bipolar electrodes. Patient's selection criteria were: stable spinal cord lesion between T7 and T11, minimum 1 year after the accident without deformity of the spine, the muscle groups for locomotion responding to external FES with the EXOSTIM programmer with the same programme used later for the neuroprosthesis. Two paraplegic male patients, T8, 38 and 31 years old respectively, were operated on by an international group of surgeons according to the protocol in 09/1999, respectively 7/2000. The postop. course was uneventful. Because the threshold of the primary implant was too low regarding scare tissue around the electrodes, this implant was changed in 01/2000 and worked perfectly. Both patients are happy with the success of the novel treatment modalities.

The contribution of echocardiography in the management of thrombo-embolic disease.

To evaluate the contribution of echocardiography on the management of acute pulmonary embolism (A.P.E.) a study was carried out on 84 patients. For each of them echocardiography was performed: (a) the M mode shows an increase in RVDD/LVDD quotient correlated with the gravity of the A.P.E.; (b) the two dimensional mode allows 9 times the discovery of a thrombus which could be: static and broad based 6 cases or mobile, large sized 3 cases. So echocardiography can be systematically and initially be proposed for any patient suspected of having A.P.E.; (c) the absence of increase in RVDD/LVDD ratio 0.33 exclude the possibility of a serious A.P.E. and it is possible to postpone the pulmonary angiogram. On the contrary the increase of the RVDD/LVDD ratio must lead to the angiographic exploration due to the seriousness of A.P.E.: (d) the discovery of a mobile, large sized thrombus with hight embolic potential makes the catheterism of the right cavities dangerous and lead to an emergency embolectomy because of the high risks of a new A.P.E.

Value of real time B mode ultrasound imaging in the diagnosis of deep vein thrombosis of the lower limbs.

In order to determine the value and the role of real time B mode ultrasound imaging (USI) in the diagnosis of deep vein thrombosis (DVT) of the lower limbs, it was compared to bilateral contrast ascending venography used as a standard of reference, prospectively and systematically on 430 patients suspected of having DVT or pulmonary embolism. A total of 854 limbs were thus studied double blindly both by the two methods. The results corresponded in 95% of the legs with a sensitivity of 98% and a specificity of 95% for USI. Isolated thrombosis of the calf were detected in 91% of the legs and proximal thrombosis were in 100% in this series whatever their topography and extent should be and whatever be the degree of obstruction of the vein. The discrepancies between the two methods are related to: (a) Vein thrombosis especially located in the calf, in the soleal sinuses and the gastrocnemius with in most cases the direct image of the thrombus detected by U.S.I. more often than by venography, provided that the technique and the equipment are appropriate. (b) The absence of visualisation of venous segments with venography which is not specific of venous thrombosis. These veins when non affected by the thrombosis are not filled by the contrast medium if located above an occluded ilio-femoral or ilio-caval junction or when they are the site of extrinsic compression. The direct imaging of the vein and the surrounding structures obtained with USI enhances the diagnostic sensitivity and specificity and provides precision of the exact extension of the thrombosis. Venous study by USI is always coupled with the Doppler.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of two-dimensional echocardiography with scanography and indium-111 platelet scintigraphy in detection of intracardiac thrombi.

The authors compare three diagnostic-imaging methods (two-dimensional-echography, heart scans and indium-111 platelet scintigraphy) used in the detection of intracardiac thrombi in 82 patients. They attempt to define their respective diagnostic values in the presence of left ventricular and atrial thrombi.

[Provocation tests for coronary spasm. Methods, value and indications]. / Les tests de provocation du spasme coronarien. Méthodes, valeur et indications.

Five methods are currently used to demonstrate coronary spasm: they use derivatives of ergotamine, alkalinisation, cold, adenosine triphosphate and exercise stress test. The criteria used to confirm spasm are either direct visualisation at coronary angiography or indirect electrocardiographic changes. The value of these test is beginning to be established: --their specificity is excellent with all methods (a positive test is diagnostic); --their sensitivity is mediocre (a negative test does not exclude the diagnosis). This depends on three factors: the choice of criteria of positivity: angiographic appearances is the most reliable; the timing of the test: it is more likely to be positive when the test is carried out close to episodes of chest pain; the method of provocation: the most sensitive tests use either the ergotamine derivatives or alkalinisation; --reproductibility is satisfactory at short and long term. These tests have diagnostic and therapeutic indications. It is preferable to perform diagnostic tests during coronary angiography in patients with normal coronary arteries and unexplained episodes of chest pain. However, in patients with fixed coronary lesions (except triple vessel and left main stem disease) when coronary bypass surgery is planned, the results of the test can help in the choice of associated therapy, such as plexectomy and calcium antagonist drugs. The repetition of the test is useful in the evaluation of antispastic therapy: when the test becomes negative the drug used is probably effective. In conclusion, with equal patient comfort and MSR, provocation tests using the ergotamine derivatives would seem to be the method of choice: alkalinisation is a good alternative.

[Genesis of myocardial infarction]. / Genèse de l'infarctus du myocarde.

The causes of myocardial infarction (MI) are complex and multiple and may eventually be associated. Two main types of mechanism are thought to be implicated: Functional mechanisms: these are operative in prolonged angina: the difference between MI and angina pectoris is related to the duration of these phenomena and to the resistance of the myocardial cells to anoxia: unsatisfied increase in myocardial oxygen demand, as for example in exercise-induced myocardial infarction; sudden reduction in oxygen supply due to an excessive fall in coronary flow, inadequate vasodilatation, platelet aggregation or coronary spasm. Priviledged cases are presented to demonstrate the reality of these phenomena. These mechanisms can sometimes cause MI by themselves, even when the coronary arteries are normal (5% of cases), and nearly always complicate and aggravate obstruction due to an atheromatous plaque. Organic obstructive lesions: coronary obstruction observed in about 2/3 of cases, sometimes caused by rupture of an atheromatous plaque, is usually the result of coronary thrombosis. The predominance of this mechanism is an argument in favour of it being the principal cause of MI. However, other workers believe that thrombosis is a secondary phenomenon induced by stasis, functional mechanisms or severe stenosis. The clot itself would then cause obstruction even if the primary cause were to regress. Irrespective of the roles of each of these factors it would appear logical to treat the functional mechanisms assumed to be responsible and the coronary thrombosis before the myocardial cells are destroyed by the anoxia.

[Detection of arterial thrombi using blood platelets labeled with indium-111]. / Détection des thrombus artériels par les plaquettes marquées à l'indium 111.

Scintigraphy with Indium 111-labelled platelets was carried out in 62 patients (37 transient cerebral ischaemic accidents, 21 lower limb ischaemic episodes and 4 aortic aneurysms) to detect arterial thrombi. The results of this investigation were compared with the surgical findings and showed this to be a satisfactory method of detecting haematologically active thrombi.

[Antihypertensive effect of a new form of nifedipine compared to a beta-blocker during chronic administration]. / Etude de l'effet antihypertenseur d'une nouvelle forme de nifédipine comparée à un bêtabloqueur en administration chronique.

The aim of this study was to test the efficacy of a 20 mg tablet preparation of nifedipine alone in twice daily dosage, in the treatment of moderate hypertension (95 greater than or equal to DBP less than or equal to 115 mmHg). Efficacy was defined as the ability to maintain treatment for 6 months with a fall in DBP of a least 5 mmHg after the first month, and with a DBP 100 mmHg from the second month. One hundred and seventy seven patients were recruited from november 1981 to december 1982, 55% during the first three months of the trial. There were 95 men (54%) and 82 women, with a mean age of 55.6 +/- 10 years. The DBP ranged from 96 to 111 mmHg in 80% of cases. The patients were randomly allocated in lots of 6, to three groups: placebo (58 patients), nifedipine (57 patients) and acebutolol (61 patients). The comparability of 21 parameters amongst these 3 groups was verified. After 1 month of placebo, 25 patients did not meet the criteria of inclusion and were excluded from the study. During this phase, 19 patients (10.5%) complained of at least one side effect. Of the 152 patients who received active treatment, 34 (22.4%) were "wrongly included", 17 did not complete the test period for undefined reasons and were considered to have been "lost to follow-up", and 6 patients "deviated" from the protocol. These 3 groups were taken into account in the statistical analysis of the graphs of non-failure.

[Repeated coronarographies in 122 medically treated patients]. / Coronarographies itératives chez 122 patients traités médicalement.

122 patients treated medically 115 men and 7 women aged 51.9 +/- 8.51 years (range 32 to 79 years) underwent repeat coronary angiography 34 +/- 26 months (1 month-11 years) after the initial investigation Patients with normal coronary arteries were excluded. The repeat investigation was performed for aggravation and persistance of symptoms in 74 cases, myocardial infarction in 14 cases, with a view to aortocoronary bypass in 23 cases, for cardiac failure in 8 cases and for ventricular arrhythmias in 3 cases. Three groups of patients could be distinguished: Group I: the coronary angiography was unchanged (41 patients, 33.6 p. 100). The interval between the two investigations was 30.7 +/- 24.8 months. Group II: the coronary lesions had regressed in 12 patients (9.8 p. 100). The interval between the two investigations was 29.4 +/- 23 months. The degree of stenosis was reduced in 6 cases; recanalisation of an occluded artery was demonstrated in 3 cases; coronary spasm was diagnosed in 3 cases. Paradoxically, 4 patients had developed lesions on other coronary segments. Group III: the coronary lesions had progressed in 69 patients (56.6 p. 100). The interval between the two investigations was 36.8 +/- 26.9 months. The progression was observed on a pre-existing stenosis in 51 cases and on an initially normal segment in 34 cases. Left ventricular function had worsened in 21.7 p. 100 of patients compared to only 5.6 p. 100 of patients in groups I and II (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)