[Measurement of peak expiratory flow and altitude]. / Mesure du débit de pointe et altitude.

Readings of peak-expiratory flow rate (PEFR) in twelve healthy alpinists at sea level (Lima) and at 3800 m (Yanganugo) show a significant slight fall with altitude (p less than 0.05). This study corroborates previous reports (Singh et al., 1969; Stockley et al., 1979). However, Forster (1983) taking in account the effect of air density on the functioning of peak-flow meter suggested that actual PEFR increases slightly with altitude. In the present study, corrected data show an increase of PEFR by about 3% at 3800 m, similar to Forster's results (at 4200 m). Air density must be considered in future studies in altitude and in estimation of clinical improvement of asthmatic people living in mountain health resort.

[Arrhythmogenic right ventricular dysplasia revealed during anesthesia]. / Révélation lors de l'anesthésie d'une dysplasie ventriculaire droite arythmogène.

Bigeminism appearing during pelvic laparoscopy led to the diagnosis of arrhythmogenic right ventricular dysplasia. It is a recently identified specific anatomical and rhythmic entity which gives rise to ventricular tachycardia in the young patient. When anti-arrhythmic drugs become inefficient, surgical treatment may be necessary (ventriculotomy). The anesthetic technique must be chosen so as to avoid setting off the abnormal rhythm. When an expected arrhythmia occurs in the operating theatre, it is inherent either to the surgery, the anaesthetic or the patient. Arguments in favour of cardiac disease are: the common occurrence of cardiac disease, preoperative abnormal ECG or chest X-ray, the mechanism of the arrhythmia (reentry) and the timing of its appearance. This arrhythmia is likely to disappear under light general anaesthesia. Functional abnormalities (anxiety, hypercapnia, hypoxia, acidosis, hypokalemia) should be treated before carrying out other specialized tests, such as cardiac ultrasonography.