[Serum protein immunofixation in malignant hemopathies other than multiple myeloma and Waldenstrom's macroglobulinemia]. / Immunofixation des protéines sériques dans les hémopathies malignes autres que le myélome multiple et la maladie de Waldenström.

The interest of serum protein immunofixation in myeloma and Waldenstr m's macroglobulinemia is widely known. It is not so well defined in other malignant hemopathies. The purpose of this study was to determine immunofixation abnormalities in malignant hemopathies other than multiple myeloma and Waldenstr m's macroglobulinemia. We selected serum immunofixations of 61 patients affected by malignant hemopathies and 53 patients affected by other pathologies susceptible to give immunofixation's alterations. We showed that the frequency of immunofixation abnormalities was more important in patients affected by malignant hemopathies than in patients affected by other pathologies (70.5% vs 35.8%). A high frequency of monoclonal immunoglobulins was found in patients with lymphoma (53.3%) and oligoclonal immunoglobulins in other hemopathies (48.2%). No significant difference of the frequency of the monoclonal immunoglobulin isotypes was found. In summary, this retrospective study demonstrates a high frequency of immunofixation abnormalities in malignant hemopathies other than multiple myeloma and Waldenstr m's macroglobulinemia and different immunofixation characteristics between lymphomas and other hemopathies.

Haemodynamic response to an isometric exercise test in obese patients: influence of autonomic dysfunction.

OBJECTIVE: To investigate blood pressure (BP) and heart rate (HR) responses to an isometric exercise test in obese non diabetic patients and to correlate the results with vagal function and plasma insulin concentration. SUBJECTS: 63 obese patients, 36 of whom had abnormal cardiac parasympathetic control (PS+), and 35 healthy control subjects. METHODS: Analysis of HR variations during three standardized tests: deep-breathing, lying-to-standing and Valsalva. Isometric contraction (handgrip) for 5 min. RESULTS: In the PS+ obese patients, resting HR and body mass index (BMI) were significantly higher than in the PS- subjects and there was a trend to higher plasma insulin concentrations. Age-matched comparison showed that during the handgrip test, the increase in HR at the first minute was significantly higher in the PS- obese patients than in the controls. The increase in BP was significantly lower in the PS+ obese patients than in age-and-BMI-matched PS- obese patients. CONCLUSION: These data suggest that 1) there is an increase in cardiac vagal tone in PS- obese patients, since the early increase in HR at 1 min of the handgrip test, results from the withdrawal of vagal tone; 2) BP response to an isometric contraction is impaired in PS+ obese patients due to a lower sympathetic activation; 3) high plasma insulin concentrations may also contribute to limiting the BP response; and 4) autonomic disorders may account for alterations in the haemodynamic changes during exercise.

[Global approach to diarrhea in children in Vietnam: the experience of Ho Chi Minh City no. 1 pediatric hospital]. / Approche globale des diarrhées de l'enfant au Vietnam: l'expérience de l'hôpital pédiatrique no 1 de Hô Chi Minh Ville.

Since 1988, within the framework of the national programme for the fight against diarrhoeal diseases in children in Vietnam, the paedriatric hospital number one of Ho Chi Minh City has developed a unit for treatment of diarrhoea which has become a reference centre for the south of Vietnam. The unit for treatment has developed an integrated approach for caring for dirrhoea in newborns, insisting on oral rehydration, non-prescription antibiotics, improving nutritional status, and education of parents which not only aims to allow for a more effective treatment of sick children, but also to increase the principles of prevention and care in the community. The results of this programme are spectacular in terms of reduction of its lethalness and the decrease in hospitalisations toward out-patient care. The unit for treatment of diarrhoea, which has become a collaborating centre of WHO, is also a tool for training health personnel in the south of Vietnam and a centre for clinical, epidemiological, economic and evaluative research of diarrhoea in children.

[Insulin resistance and essential hypertension in Vietnamese subjects]. / Insulinorésistance et hypertension artérielle essentielle chez les Vietnamiens.

Several epidemiological and experimental studies suggest that essential arterial hypertension is associated with hyperinsulinism and insulin resistance in obese subjects and also in subjects with normal body weight. Undernutrition remains frequent in adult Vietnamese people and mean body mass index is around 18.5 kg/m2 in Vietnam. The aim of this study was to look for insulin resistance in hypertensive Vietnamese subjects, despite a markedly lower BMI in Vietnam than in occidental countries. One hundred and eight hypertensive patients (51 men and 57 women) over 40 years (mean = 65.4 years) were compared with 36 healthy subjects (23 men and 13 women) over 40 years (mean = 63.8 years). Hypertensive patients had significantly higher BMI (20.5 +/- 0.3 (SEM) kg/m2 vs 18.4 +/- 0.4 kg/m2; p < 0.01), thicker triceps skinfold (1.26 +/- 0.07 cm vs 0.71 +/- 0.07 cm; p < 0.001) and not significantly different waist/hip ratio (0.88 +/- 0.01 vs 0.85 +/- 0.01). Blood glucose at fasting and 2 hours after 75 g glucose taken orally were similar in hypertensive and normotensive subjects. Plasma insulin at fasting and 2 hours after glucose were significantly higher in hypertensive patients (44.4 +/- 5.1 pmol/L vs 21.6 +/- 3.2 pmol/L; p < 0.05 and 271.1 +/- 21.6 pmol/L vs 139.1 +/- 15.2 pmol/L; p < 0.001). Thus, despite under-nutrition, hypertensive Vietnamese patients have a moderate but significant increase in BMI and fat mass without predominant abdominal localization, and a state of insulin-resistance, compared with normotensive healthy subjects.