[Leg muscle bed syndrome: medical aspects of chronic forms]. / Le syndrome des loges de jambes: aspects médicaux des formes chroniques.

Ninety two patients with lower leg pain of unknown cause underwent intramuscular pressure measurements by the needle technique described by Whitesides. Fifty four patients (59%) were found to have a chronic compartment syndrome. In these patients the intramuscular pressure was significantly increased at rest and after exercise as compared with normal subjects (13) and patients without the syndrome (38). Increased pressure at rest after exercise and a prolonged time for normalisation are the most commonly parameters in diagnosing chronic compartment syndrome. Tissue pressure measurement remains the basis of diagnosis for patients suffering from chronic compartment syndrome, indeed the clinical findings alone were found to be insufficient. Effective treatment consists of reduction of exertional activities or decompression by fasciotomy. The clinical results after fasciotomy were good and consistent with the findings of others.

[Baroreflex and blood pressure variations in borderline hypertension of the young adult]. / Baroréflexe et variabilité tensionnelle dans l'hypertension artérielle limite de l'adulte jeune.

Blood pressure (BP) variability depends on external and internal factors. Among these, arterial baroreflex play an important role. The matter of this study is to assess the relationship between these two parameters in borderline hypertension (BL). Twenty six BL male hypertensive were recruited for the study, all gave informed consent. Age: 21 +/- 2 years, height: 177 +/- 8 cm, weight: 77 +/- 14 kg. An ambulatory BP monitoring was performed in each one using a Diasys (Novacor) recorder. Measurements were obtained each 15 minutes for 24 hours. Mean, standard deviation and variation coefficient (VC) of BP and heart rate (HR) were computed for 24 hours, daytime (9a.m.-7 p.m.), nighttime (11 p.m.-7 a.m.). Baroreflex sensitivity (BRS) was determined as the ratio of HR variation on systolic BP variation recorded with a Finapres device from the fourth phase of a Valsalva manoeuvre. Mean systolic and diastolic BP values for 24 hours, daytime and nighttime are: 129 +/- 11/73 +/- 13, 137 +/- 14/76 +/- 15, 114 +/- 11/69 +/- 12 mmHg. VC are: 12 +/- 3/15 +/- 3, 9 +/- 3/13 +/- 3, 10 +/- 3/13 +/- 4%. HR values are: 73 +/- 10, 84 +/- 14, 58 +/- 7 b/min, VC are: 24 +/- 5, 17 +/- 4, 17 +/- 7%. Index for BRS = 1.76 +/- 0.65%. There is no correlation between BRS and systolic BP or HR. BRS is correlated to the inverse of systolic daytime BP VC: r = -0.556, p = 0.003. There is no correlation with other parameters. This study provides evidence for a link between BRS and daytime BP variability in borderline hypertension.

[Study of representative periods of day-time and night-time levels of blood pressure]. / Recherche de tranches horaires représentatives des niveaux tensionnels diurnes et nycthéméraux.

UNLABELLED: The aim of this study is to assess whether it is possible to shorten ambulatory blood pressure (ABP) monitoring while getting measurements that precisely reflect 24 hours and daytime blood pressure (BP). METHODS: three hundred and thirty six young male subjects aged: 21 +/- 2 y, height: 178 +/- 7 cm, weight, 75 +/- 12 kg, with normal or "borderline" BP (casual BP: 138 +/- 13/79 +/- 8 mmHg) participated in the study. BP was recorded in each, every 15 minutes on 24 hours with a Spacelabs 5200 device. Systolic and diastolic BP on 24-h, during the 9 a.m. - 8 p.m. period (daytime) and BP related to the different subperiods included between 15 minutes and 6 hours were calculated. BP values obtained from the 196 subperiods were correlated with 24-h, daytime ABP and causal BP. Results were classified according to the value of correlation coefficient, slope and intercept of regressions. RESULTS: no subperiod accurately predict 24-h systolic BP (SBP) or diastolic BP (DBP) (the best correlation are established with the subperiods: 7 p.m.-01 a.m. for SBP; r = 0.916, p less than 10(-9), y = 0.76 x + 30; and 06 a.m.-12 a.m. for DBP; r = 0.914, p less than 10(-9), y = 0.87 x + 9). Four 6 hours subperiods sampled between 09 a.m.-3 p.m. and 12 a.m.-6 p.m. predict alike and in a reasonable way the daytime BP (SBP: r = 0.971, p less than 10(-9), y = 0.94 x + 8; r = 0.973, p less than 10(-9), y = 0.91 x + 7. Best correlations with casual BP are moderate (SBP: r = 0.674, DBP: r = 0.588). COMMENTS: BP measurements of subperiods smaller or equal to 6 hours cannot accurately predict the average 24-h BP. This is related mainly to the night-time/daytime BP fluctuations. Daytime BP can be estimated with short-term monitoring but the duration must not be smaller than 6 hours.