[Alveolitis: review of the literature]. / Les alvéolites: revue de littérature.

Alveolitis are infectious complications following the dental extraction. They appear under two forms: dry, characterized by a painful syndrome and uninhabited alveolus, and suppurative, which becomes identified by provoked pain and alveolus filled. Their etiopathogenesis remain a subject of interrogation because of the rarity of studies concerning this complication. Nevertheless, treatment is mainly favorable by a sedation of the pain and the startup of a physiological healing. From this article, we are going to review their clinical forms, their etiology as well as the followed treatment.

Seasonal variations in the function of the endocrine pancreas in Psammomys obesus.

The aim of this work was to determine whether Psammomys obesus living in its natural habitat displays variation in the function of the endocrine pancreas. Live animals were collected regularly through the year by strip sampling. Plasma glucose varied during the year. Glucose levels were higher in periods I and III (autumn and spring) than in periods II and IV (winter and summer). Pancreatic insulin contents were higher in periods I and II than in periods III and IV. Plasma insulin also varied with the season in synchrony with glucose variations except during period IV, in which elevated levels of insulin were associated with low levels of glucose. The high insulin levels observed in period IV were resistant to the effects of food restriction in that period and were probably related to the presence of the greater levels of insulin in period III (spring). The dry season (period IV) corresponding to the period of restricted diet appears necessary to restore elevated levels of insulin to baseline. Morphometric quantitation of the insulin, glucagon, and somatostatin positive islet cells did not reveal seasonal variation. However, the volume density of A and D cells in P. obesus reached high values of 32 and 15%, respectively. The volume density of insulin cells amounted to about 53%. It is concluded that P. obesus living in its natural habitat is a nondiabetic healthy gerbil adapted to desert subsistence by endocrine feedback, imposed by the seasonal variation in food availability.

[Fatal hepatitis in a young child: probable role of halothane]. / Hépatite fatale chez un jeune enfant: rôle probable de l'halothane.

A 3-year-old boy, who underwent multiple anaesthetics including halothane in a short period of time, developed 3 days after the last operation abdominal pain, jaundice and fever. Laboratory tests showed hepatic failure, with cytolysis, cholestasis and eosinophilia. Tests for hepatitis A, B, C, CMV and EBV were negative. No other causes of postoperative jaundice were identified. Despite symptomatic treatment, the child died 5 days after the last anaesthetic. Post mortem liver biopsy showed massive hepatic necrosis. The authors discuss factors increasing the risk for halothane-hepatitis, especially multiple exposures.

[Prevention of postoperative nausea and vomiting by lorazepam]. / Prévention des nausées et vomissements postopératoires par le lorazépam.

This study was carried out to assess the efficacy of oral lorazepam on postoperative nausea and vomiting in patients undergoing thyroid surgery. Twenty-six patients were randomly assigned to two groups, and receiving orally, one hour before induction of anaesthesia, either 2.5 mg of lorazepam (n = 13) or a placebo (n = 13). Lorazepam reduced the incidence and especially the intensity of nausea. The incidence of vomiting in the lorazepam group was significantly lower than in the placebo group (14.5% vs 45%). The use of lorazepam for premedication thus reduces the incidence of postoperative nausea and vomiting. The advantages of this benzodiazepine are its ease of use, low cost and very low incidence of side effects.

[Maternal prognostic factors in severe eclampsia]. / Les facteurs du pronostic maternel dans l'éclampsie grave.

Sixty cases of severe eclampsia were treated in an intensive care unit between January 1989 and September 1993. Mean age was 26, and 70% of patients were primipara. The pregnancy has been unsupervised in almost all cases. All had visceral lesions and/or hematologic problems and there was impaired conscious level in 9 cases out of 10. Medical treatment involved the control of seizures and of hypertension. Cesarean section was performed in 34 cases. The maternal death rate was 23.3%. Our experience indicates that mortality depends upon visceral lesions (cerebral, disseminated intravascular coagulation, acute pulmonary edema, Hellp syndrome). Better awareness of severity factors in preeclampsia improves both maternal and fetal prognosis by precisely indicating the best time for fetal extraction.

[Guillain-Barre syndrome and pregnancy]. / Syndrome de Guillain-Barré et grossesse.

A case of polyradiculoneuritis, resembling Guillain-Barre syndrome, was reported during the sixth month of a first gestation. The patient was seventeen years old and also had toxaemia of pregnancy. The interaction between polyradiculoneuritis and pregnancy is slight and carries little risk of prematurity. Plasma exchange procedures can be used in pregnant women and the results of this treatment are similar to those in patients presenting with polyradiculoneuritis alone.

[Acute pancreatitis and pregnancy]. / Pancréatite aiguë et grossesse.

Acute pancreatitis during pregnancy is a serious condition and diagnosis is often difficult. The authors report the case of a 32-year-old woman in the 32nd week of her fifth pregnancy, in which the outcome was fatal for both mother and child. The cause of pancreatitis during pregnancy has been attributed to many factors, chiefly cholelithiasis. A number of recent studies have shown the relationship existing between the role played by pregnancy in predisposing to gallbladder disease with lithiasis. Many diagnosis errors are made in this condition. Thus modern treatment methods have improved the prognosis in acute pancreatitis but, when it occurs during pregnancy, diagnostic delays often lead to a gloomy outlook.

[Preventive treatment of hemodynamic disorders during conventional spinal anesthesia]. / Traitement préventif des perturbations hémodynamiques au cours de la rachianesthésie conventionannelle.

The prevention of blood pressure fall during a conventional spinal anaesthesia effected with 20 mg (4 ml) of isobaric 0.5 p. 100 bupivacaine relies on the use of vascular filling and/or a vasoconstrictor. A randomized prospective study was performed to evaluate the comparative efficacy of these two treatments. 148 patients were included and divided into three groups. Group I (n = 50): 2.5 mg IV bolus of etilefrine followed by continuous infusion (0.35 mg.kg-1.h-1). Group II (n = 50): 30 ml.kg-1 infusion of saline isotonic solution for 90 min, with infusion rate according to blood pressure. Group III (n = 48) did not receive any preventive treatment. A blood pressure fall of more than 30% of the initial value was observed in 59 patients: 18% of the etilefrine group, 28% of the saline infusion group, 54% of the control group. This peculiar frequency of hypotension in the control group emphasizes the need of a preventive treatment. Haemodynamic changes were fewer and less important in the etilefrine group compared with the saline infusion group. No failure and a better tolerance in the vasoconstrictor group were also to be noticed. These clinical data suggest that etilefrine could meet satisfactorily the therapeutic requirements.

Seasonal variations of androgens and of several sexual parameters in male Meriones shawi in southern Morocco.

Seasonal changes of several parameters related to sexual activity were studied in the gerbil (Rodentia: Gerbillidae). The weight of the testes, seminal vesicles, and adrenals fluctuate throughout the year. Plasma androgen levels and histological aspect of the testes also vary throughout the year. Spermatogonial and steroid activities are synchronous and are maximal in winter and spring. The relationship between these activities and environmental climatic parameters is discussed: the beginning of sexual activity seems correlated with the first rains.