[Preventive value of intravesical thiotepa on the recurrence of Ta-T1 vesical tumors treated by conservative surgery. Apropos of 247 cases a mean follow-up of 88 months]. / Valeur prophylactique du thiotepa intra-vésical sur les récidives des tumeurs vésicales Ta-T1 traitées par chirurgie conservatrice. A propos de 247 cas suivis avec un recul moyen de 88 mois.

The retrospective homogeneous study of 247 patients with follow-up from 12 months to 384 months (mean 88 months) and managed with or without intra-vesical instillations of thiotepa as prophylactic chemotherapy after surgical conservative treatment is compared with some literature's data principally multicentric randomized series. Statistics contradictions remain with no significative results for possible progression towards infiltration, better "free interval" between recurrences, and better recurrence rate for 100 patients/months. In this series the number of tumors recurrences in each bladder was evaluated: this mean rate of tumors recurrences/year is 1,7 without prophylactic thiotepa and only but always 1,08 with thiotepa. Prophylactic instillations chemoprophylaxy seems to be justified but must be emphasized: mitomycin C, BCG therapy would be better in the future?

[Vitamin D deficiency in long-stay geriatric patients. Study of a therapeutic protocol adapted to the institutional milieu]. / Carence en vitamine D chez le vieillard hospitalisé en long séjour. Etude d'un protocole de correction adapté au milieu institutionnel.

A vitamin D deficiency was observed in 22 women and 6 men aged 66 to 94 years, hospitalised in a long-stay department in the Paris region for an average of 5 years and incapable of going out. The diagnosis was confirmed by measuring serum 25 (OH) D: 1.89 +/- 0.18 ng/ml during the month of June (11.5 +/- 4.2 ng/ml at the same period in II healthy young adults). The patients were randomly divided into two groups of 11 (Group I) and 17 patients (Group II). The first group was given an improved diet in calcium and Vit. D; the second group received, in addition, an intramuscular supplement of 30 mg of Vit. D3 in monthly injections of 5 or 10 mg. The serum 25 (OH) D levels were measured each month in both groups. Patients with intramuscular supplements showed a slow rise until the total injected dose exceeded 20 mg, followed by a sudden rise to values greater than 30 ng/ml. Eight months after the last injection, mean serum 25 (OH) D was still 24.7 +/- 4.6 ng/ml compared to only 3.6 +/- 3 ng/ml in Group I. Vitamin D deficiency in geriatric patients cannot be corrected by dietary supplement alone, but parenteral Vit. D3 using an easily applicable therapeutic protocol is effective and well tolerated at the suggested dosage.