[In process]. / Insomnie, anxiété: faut-il réguler la prescription des benzodiazépines?

Benzodiazepine hypnotics bear a higher risk of high dose dependence than benzodiazepine anxiolytics, according to a recent study in Luxemburg. This article summarizes the main indications of these molecules and the current treatment recommendations. It provides an overview of public health actions of the past and the future to reduce their excessive consumption.

Non-Hodgkin's lymphoma: time trends for incidence and survival in Côte-d'Or, France.

BACKGROUND: A generally reported increased incidence of non-Hodgkin's lymphomas (NHL) and a recent evolution in treatment strategies, as well as several clinical trials suggesting improved survival, have prompted this study to evaluate time trends in incidence and prognosis of NHL. METHOD: NHL recorded by the population-based Registry of Hematopoietic Malignancies in Côte-d'Or (France) were considered over three 4-year periods from 1980 to 1992. A multivariate survival analysis was carried out in terms of both crude and relative survivals. RESULTS: Overall incidence, increased over the 12 years considered, by an average of 6.8% per annum (P < 0.05). Only two cases of AIDS-related NHL were registered during this period. NHL incidence has increased slightly more for males than for females, further widening the gap in incidence between the sexes. In terms of histological grade the increase in incidence was more pronounced for low-grade and high-grade NHL than for intermediate-grade NHL. The overall 5-year relative survival rate was 69.3%. In multivariate relative survival analysis, neither sex, age, period of diagnosis nor place of hospitalization were significant prognostic factors. Only place of residence, with RR 2.2 (1.41-3.42) for people living in rural areas compared to urban areas and histological type, according to the working formulation with RR 3.8 (2.22-6.61) for high-grade tumours compared to low-grade tumours, remained informative for prognosis. CONCLUSIONS: Although incidence of NHL has increased in Côte-d'Or, this trend has remained independent of the AIDS epidemic. Contrary to the findings of clinical trials, the patients' survival in this population-based series has not been shown to have improved over the study period.

Multiple primary cancers in the Vaud Cancer Registry, Switzerland, 1974-89.

Data collected by the Cancer Registry of the Swiss Canton of Vaud (whose population in 1980 was about 530,000 inhabitants) were used to estimate the incidence of second metachronous primary cancers following any specific neoplasm. Among 34,615 cases of incident neoplasms registered between 1974 and 1989 and followed through integrated active follow-up to the end of 1989, for a total of 118,241 person-years at risk, there were 2,185 second primaries (1,280 males, 905 females). For both sexes, the standardised incidence ratios (SIR) were significantly elevated by about 20%. Overall significantly elevated ratios were registered for cancers of the oral cavity and pharynx (SIR = 1.6 for males, 2.0 for females), oesophagus in males (SIR = 1.5), lung in males (SIR = 1.4), skin melanoma (SIR = 1.7 for males, 1.5 for females), non-melanomatous skin cancers (SIR = 1.6 for males, 1.5 for females), female breast (SIR = 1.3), kidney (SIR = 1.5 for males, 1.9 for females), and thyroid in males (SIR = 2.4). When specific first cancer sites were considered, the SIR following a cancer of the oral cavity and pharynx was around 3 in both sexes, mainly on account of a substantial excess of second primaries of the oral cavity, oesophagus, larynx and lung. The overall SIR following laryngeal cancer was 3.0, and significant excesses were observed for oral cavity and pharynx, oesophagus and lung. After lung cancer, the overall SIR was 1.7 for males and 2.6 for females, and significantly elevated SIRs were observed for oral cavity, lung and oesophagus. Following non-melanomatous skin cancers, elevated SIRs were observed in both sexes for skin melanoma and non-melanomas. The incidence of any cancer after breast cancer was significantly elevated (SIR = 1.2), mainly on account of an elevated risk of subsequent breast cancer (SIR = 1.7). With reference to cervical cancer, there was a significant excess for any subsequent primary (SIR = 1.6), and for lung cancer (SIR = 7.8). Significantly elevated SIRs were observed for kidney following bladder cancer, and for bladder after kidney cancer. In both sexes, the incidence of cancers of any site was elevated following leukaemias (SIR = 1.7 for males, 2.5 for females), and a significant excess was registered for lung in males and non-melanomatous skin cancers in both sexes.(ABSTRACT TRUNCATED AT 400 WORDS)

Linkage of death certification of AIDS and cancer registration in Vaud, Switzerland.

58 death certifications (40 males and 18 females) of residents of the Canton of Vaud (Switzerland) which reported AIDS as the cause of death in 1986-1989 were matched with the list of incident cancers available since 1974 from the Vaud Cancer Registry. Such linkage was successful for 20 individuals (age range 25-63, median 37), mostly males (18/20), homosexual or bisexual (11/18) and affected by Kaposi's sarcoma (14 males and 1 female). Other identified neoplasms included one Burkitt's lymphoma, one prostate adenocarcinoma and one multiple myeloma (whose histological picture included, however, lymphocytosis in addition to plasmocytosis). Three additional malignancies (one undifferentiated skin cancer, one carcinoma of the salivary glands and one in situ cervical carcinoma), and one myelodysplastic syndrome had also been diagnosed from 1 to 2 years before AIDS death. Cancer was mentioned on the death certificate, in addition to AIDS, in only 2 cases. Albeit of limited size, the present report confirms that a systematic integration of AIDS and cancer registration statistics provides additional information, of particular interest for histological classification, on the AIDS-cancer relationship.