[The role of various forms of ribomunyl in recurrent respiratory tract infections]. / Place des différentes formes de ribomunyl dans les infections récidivantes des voies aériennes.

Ribomunyl was administered in an open clinical trial for the treatment of chronic repetitive infectious diseases of the upper respiratory tract. Two groups of patients were treated with either Ribomunyl aerosol (n = 19) or with Ribomunyl aerosol and injections (n = 17); a third group of 17 patients, serving as a control group, did not receive treatment with either form of Ribomunyl. The treatment lasted two months and was followed by an observation period of another four months. The patients treated with Ribomunyl showed a distinct improvement compared to the untreated group. Ribomunyl was generally well tolerated. Plasma antibodies determined before, during and after the trial showed a clear-cut relationship between the increase in plasma antibody levels and improvement of clinical picture.

[Value and limits of urinary protein electrophoresis with sodium dodecyl sulfate in the evaluation of glomerular nephropathies]. / Intérêt et limites de l'électrophorèse des protéines urinaires traitées au dodécyl-sulfate de sodium dans l'évaluation des néphropathies glomérulaires.

Qualitative analysis of urinary proteins is contrasted with histological findings of 45 renal biopsies performed in patients with chronic glomerulonephritis. Compared to electrophoresis on cellulose acetate and immunoelectrophoresis, a method using polyacrylamide gel after sodium dodecylsulfate treatment makes for more refined and objective differentiation of protein abnormalities. On the whole, proteinuria of the selective glomerular or physiological type predominates in the event of minimal change or membranous lesions. The non-selective type is found more frequently with diffuse proliferative or membranoproliferative glomerulonephritis (p less than 0.025). There are, however, too many exceptions to this rule to allow certainty, and a precise diagnosis of the particular type of glomerulonephritis is thus only possible histologically. Each type of histological involvement may cause almost any of the qualitative abnormalities of proteinuria. On the other hand, qualitative analysis of urinary proteins is useful for the detection of glomerulonephritis. A glomerular type of proteinuria may sometimes reveal involvement of kidneys at a time when, quantitatively, there is no proteinuria. In cases of orthostatic proteinuria a persistent glomerular type of tracing in recumbency suggests an organic kidney ailment. All patients in this series had a glomerular type of proteinuria when excretion was pathological, thus allowing a distinction from pure tubular involvement. 10 patients of the group, however, although they clearly had glomerular lesions (3 were diffuse proliferative glomerulonephritis) showed perfectly normal proteinuria both quantitatively and qualitatively. This was the case in systemic lupus erythematosus where kidney biopsy was performed without clinical suspicion of renal involvement. In summary, qualitative abnormalities of proteinuria call attention to underlying glomerulonephritis, although no distinction can be made between the various forms and there may be no detectable abnormality even in the event of major kidney involvement.

[Extramembranous glomerulitis. Apropos of 92 cases]. / Glomérulites extramembraneuses. A propos de 92 observations

92 cases of extramembranous glomerulitis (EMG) documented by histology and immunofluorescence have been studied. At the time of renal biopsy the clinical and biologic picture was as follows: no proteinuria in 2%, isolated proteinuria in 18%, nephrotic syndrome without hypertension or azotemia in 41%, and hypertension and/or azotemia associated with proteinuria or nephrotic syndrome in 39%. A possible cause of the EMG was found in 27 cases: it was drug-induced or toxic in 10 instances, paraneoplastic in 7, lupus in 5 and parasitic (loasis) in 5.65 cases are regarded as idiopathic. The evolution is known in 66 cases and varies with the etiology: it is usually benign in secondary forms except the paraneoplastic cases. In the idiopathic forms it results in hypertension or more or less severe chronic renal failure in 62% of cases. The prognosis cannot be established on the basis of the initial histology. No treatment has proved effective.

[Electrocardiograms of digitalis intoxication. Reevaluation]. / Electrocardiogrammes d'intoxication digitalique

Serum digoxin concentration and ECG were recorded 111 times in 96 patients taking digoxin. The generally accepted ECG criteria of digoxin concentration seem greatly to overestimate the incidence of toxic cases. According to these criteria 63 ECGs in this study would have been regarded as toxic, whereas toxicity (defined by the association of serum digoxin elevation and clinical symptoms of toxicity) was actually present in only 11 cases.

[Treatment of kidney failure in multiple myeloma by chronic hemodialysis. Apropos of 4 cases]. / Traitement de l'insuffisance rénale du myélome multiple par l'hemodialyse chronique. A propos de 4 cas

A report of the treatment by repeated dialysis of irreversible renal failure complicating 4 cases of multiple myeloma. The latter condition continued to progress, with death occurring after three, six, eight and twenty seven months. The last case was the only one with an indiscutable haematological and clinical remission. The effectiveness of chemotherapy is the reason for the use of the artifical kidney. Treatment may be hoped to be active if the renal failure is acute, a presenting feature of the myeloma. Such a hope is practically vain if the renal failure develops progressively, in a patient already on treatment. The indication for haemodialysis is thus more than open to discussion.