[Calcification of the pectineal ligament. An usual radiological imaging in pediatrics]. / Calcification du ligament pectiné. Une image radiologique d'observation courante en gériatrie.

OBJECTIVES: Since its first description several years ago in the elderly subject, calcification of the Cooper ligament is often considered as a rare anecdotal phenomenon. We present the radiographic presentation which is often not well known. METHODS: Two experienced radiologists examined independently a series of 100 consecutive X-rays of the pelvis performed in a population of elderly subjects (mean age 84.4 +/- 9.2), looking for calcification of the Cooper ligament. RESULTS: Calcification of the Cooper ligament was observed on 7 of the 100 images of the pelvis. There was no significant difference in age, sex, or reason for ordering the examination between subjects with calcification and those without calcifications. Arterial calcifications were observed at an equal frequency. The usual aspect of the Cooper ligament was a fine opaque line following along the upper border of the iliopectinate crest. Oblique views visualized the calcification better. The line of calcification was either continuous of fragmented and was bilateral in all 7 cases. CONCLUSION: These images are apparently of no pathological significance. Clinicians should however be aware of the radiographic presentation in order to avoid confusion with visceral calcification or periosteal deposits.

[Drug interactions: study of 409 prescriptions at the time of discharge from geriatric hospitalization]. / Interactions médicamenteuses: étude de 409 ordonnances établies à l'issue d'une hospitalisation gériatrique.

In order to specify the frequency and the potential consequences of drug interactions in the elderly, we retrospectively analysed 409 discharge prescriptions. The possibility of drug interactions was screened out for each prescription in the software version of the Vidal drug compendium. It appears that prescriptions are mainly adapted to the elderly with respect to posology and pharmacokinetics. Potentially dangerous drug interactions ('contraindicated' or 'unsuitable' associations) were found in 6 per cent of prescriptions; after careful assessment, this frequency decreased to less than 1 per cent. The most common orthoergic side effects were sedation (15 per cent) and hypotension (14.5 per cent). This study points out the multiplicity of criteria to be considered in order to prevent drug interactions, and the gaps in available software.

Ergoloid mesylates ('Hydergine') in the treatment of mental deterioration in the elderly: a 6-month double-blind, placebo-controlled trial.

A double-blind, placebo-controlled trial was carried out in 97 elderly patients with age-related mental deterioration to assess the efficacy of ergoloid mesylates in improving their symptoms. Patients were allocated at random to receive either 4.5 mg ergoloid mesylates per day or a matching placebo tablet and were followed-up for 6 months after the start of treatment. Clinical examinations were performed by the doctor, using the EACG rating scale (a French version of the Sandoz Clinical Assessment Geriatric scale), and by the nurse, using the NOSIE scale, when patients entered the trial and repeated after 2, 4 and 6 months. Changes in the factors (symptom groups) covered by these scales were subjected to statistical analysis. After 6-months' treatment, a statistically significant difference in favour of the ergoloid mesylates group was observed for cognitive deficits (p less than 0.05), anxiety and mood depression (p less than 0.01), unsociability (p less than 0.01), retardation (p less than 0.05) and irritability (p less than 0.001). Treatment was very well tolerated. It was also observed that there was a progressive increase in efficacy throughout the trial; this indicates that treatment with ergoloid mesylates in patients with mental deterioration should be long-term.

[Histological aspects of congestive cardiomyopathy caused by alcohol. Comparison with so-called primary cardiomyopathies]. / Aspects histologiques de la cardiomyopathie congestive d'origine èthylique. Comparaison avec les cardiomyopathies dites primitives.

The endoventricular biopsies of nine patients with alcoholic congestive cardiomyopathy were studied under the light microscope and under the electron microscope. These were compared with the results of nine cases of primary congestive cardiomyopathy, at a similar clinical stage. In the absence of specific signs, the overall appearance on both light and electron microscopy is sufficiently suggestive to allow differentiation of the two forms of cardiomyopathy. Repeated biopsies revealed disappearance of the nuclear abnormalities after withdrawal of alcohol, which introduces a prognostic element.

[Anemia with hypersideroblastosis during anti-tuberculosis therapy. Cure with vitamin therapy]. / Anémie avec hypersidéroblastose au cours d'un traitement antituberculeux. Guérison par vitaminothérapie.

The unusual occurrence of microcytic anemia with hypochromia, high iron blood levels and excess of sideroblasts in the bone marrow, observed during the treatment of tuberculosis with isoniazid and rifampicine is reported. Three particularities were noted. First, in our experience, the occurrence of this type of anemia has never been noted previously as a result of these two drugs. Secondly, the improvement of the blood abnormalities was obtained by the combined use of vitamin B6 and vitamin C. Thirdly, the anemia was associated with neuropathy, characterized by areflexia and dysesthesia, which improved with vitamin B6 therapy (but not with vitamin C). Some mechanisms are discussed as being possibly the origin of this kind of anemia, particularly a lack of vitamin B6 resulting from a massive urinary loss of pyridoxal induced by isoniazid as well as both a tissue depletion and an overconsumption of this vitamin. The anemia may be the consequence of a deficiency of hemoglobin synthesis involving probably the first step of the biosynthesis of heme.

[Hypokalemic familial periodic paralysis with basal electrocardiographic changes]. / Paralysie périodique familiale hypokaliémique avec modifications électrocardiographiques a l'état de base.

The authors report the case of an 18 year old girl with nocturnal tetraplegia. There was a family history of Westphal periodic paralysis, and a past history of transient paralysis two years previously. The serum potassium was 2.3 mEq/l. The patient was cured by intravenous drip of potassium chloride. There was a reactionary hyperinsulinism. The red cell potassium was lowered. There was a fall in the exchangeable and total potassium pool. The E.C.G. changes; observed during the acute attack of paralysis, persisted afterwards, which is unusual.