[Comparison of long-term course of perforating and non-perforating Crohn disease]. / Comparaison de l'évolution à long terme des maladies de Crohn perforantes et non perforantes.

OBJECTIVES: To evaluate the influence of the indication of the first surgical procedure on the prognosis of Crohn's disease. METHODS: We compared retrospectively the long-term course of 179 patients operated on for a perforating disease and 322 patients operated on for a nonperforating disease. Mean follow-up was 11 years and 2 months in the two groups. RESULTS: Forty of 179 (25%) and 106 of 322 (33%) patients with perforating and nonperforating diseases underwent a second intestinal resection, respectively. The patients who had been operated on for a perforating disease were significantly more often reoperated on for the same indication, and conversely. Patients with perforating diseases experienced less second resections (actuarial rates: 37 +/- 11% vs 51 +/- 8% at ten years respectively), less post-surgical handicaps (mean index 24.9 vs 27.9), and fewer patients required immunosuppressive drugs (25 vs 35%). CONCLUSION: Long-term prognosis of perforating Crohn's disease does not appear to be more severe than that of nonperforating disease.

[Care patterns and resumption of social and occupational activities after exeresis surgery in Crohn's disease. Study of 58 patients]. / Modalités de soins et de réinsertion socio-professionnelle après chirurgie d'exérèse pour maladie de Crohn. Une étude chez 58 patients.

The aim of this retrospective study was to describe care patterns and conditions surrounding the resumption of social and work activities after intestinal resection for Crohn's disease. Fifty-eight patients were evaluated regarding their stay in the department of surgery, use of care and resumption of social and work activities within the first year after intestinal resection. Data were obtained from medical records and answers to a medical questionnaire. Forty patients replied to the questionnaire. Mean length of stay in the department of surgery was 16 +/- 9 days. Length of stay was positively correlated to non-elective surgery, colonic resection, presence of fistulae or abscesses, and to the creation of a stoma. Main interval between surgery and resumption of work was 11 +/- 8 weeks. Only one patient was unable to return to work because of the disease. Seventy per cent of the patients who went back to work said that their quality of life was improved after surgery in comparison with their preoperative status. In conclusion, this study suggests that most of the patients undergoing intestinal resection for Crohn's disease can go back to work without particular difficulties, and consider that their quality of life has been improved by surgery.

[Trypanosomiasis: determination of groups of patients from clinical and electroencephalographic data]. / Trypanosomiase: détermination de groupes de patients à partir de données cliniques et électroencéphalographiques.

Data constituted from clinical and waking electroencephalographic signs in 104 patients at meningoencephalitis stage of trypanosomiasis were treated by way of a correspondence analysis in order to determine clinical profiles. Three profiles were identified. The first one, encountered in patients with minor clinical disturbances and slightly modified waking electroencephalographic patterns is suggestive of a cerebral involvement stage onset. The second one, observed in patients with vigilance disturbances, behavioral and motor impairment, and highly abnormal EEG tracing is indicative of a more severe encephalitis stage. The third one, obvious in patients with EEG sharp waves organized in a more or less recurring fashion and accompanied by epileptic seizures is consistent with an acute cerebromeningitis.

Evaluation de la part des boissons alcooliques autochtones dans la consommation d'alcool en Cote d'Ivoire : resultats preliminaires

Une etude epidemiologique et preliminaire de la consommation d'alcool a ete effectuee chez 314 humains adultes en Cote d'Ivoire. Les resultats montrent que l'alcool de palme; un alcool local de fabrication clandestine appele koutoukou et les bieres industrielles sont les alcools les plus consommes. Les donnees obtenues sur l'echantillon; indiquent que les alcools de fabrication locale; comme le vin de palme et le dolo (une biere de mil ou de sorgho); sont aussi tres apprecies

Effects of an acute dose of palm alcohol on normal brain functioning: an auditory, event-related-potential study.

The effects of an acute and high dose of palm alcohol (900 mg/kg bodyweight) on brain functioning were investigated in 10 healthy, non-alcoholic men. Each was given randomly-interspaced, paired, frequent standard (80%) and rare target auditory stimuli and asked to detect and signal the target tone by pressing a push button. These brain function tests were carried out before (control) and 1 and 4 h after the subjects began drinking the alcohol. During each experimental session, late, event-related-potential (ERP) components were recorded at the central midline scalp location (Cz). At both times after alcoholization, contingent negative variations and late auditory ERP were lower than those recorded during the control session. Maximal amplitude reduction for N1 and P3 waves was seen 240 min after ingesting alcohol. Reaction times were not significantly longer than those recorded pre-alcoholization but performances were lower at both times post-alcoholization. The results are consistent with the ERP changes reported in subjects under acute ethanol intoxication but they are more pronounced and probably reflect a momentary disruption of central processes rather than sensory impairment at the peripheral level.

Event-related potentials in humans as indices of access to stored information during sleep.

The even-related potentials are good indices of brain functions during sleep stages. The contingent negative variation (CNV), occurring in the interval between a conditional and a target stimulus, reflects information processing. The emitted potential which occurs when an expected stimulus is omitted reflects the access to a specific memory. During waking, deep slow wave sleep (stage 4) and paradoxical sleep seven subjects were submitted to a CNV paradigm, the target stimulus of which was occasionally omitted. The endogenous components of the evoked potentials induced at Fz, Cz and Pz locations by the auditory stimuli were analysed during the three behavioral stages. During stage 4 they were of largest amplitude and longest latency. These results are discussed in terms of neural excitability. CNV and emitted potentials were observed during waking and paradoxical sleep, but not during stage 4. These results suggest that information processing occurs during paradoxical sleep with access to waking memories during this stage of sleep, whereas information processing is absent during stage 4.

[Uniform processing of sensory-motor information and match/mismatch process impairment in man caused by chronic palm alcohol consumption]. / Traitement uniforme de l'information sensorimotrice et perturbation des processus d'appariement non appariement chez l'homme sous imprégnation chronique à l'alcool de palme.

The late components of the event-related potential (ERP) were recorded during a Go/No-Go task from 21 alcoholics (with chronic palm alcohol intoxication) divided in 3 groups of seven (abstinent alcoholics men, abstinent alcoholic women, and alcoholic men) and 14 normal adult volunteers divided into 2 groups (control men, and control women). The subjects were submitted to paired auditory stimuli and were assigned to detect and respond by pressing a push button to a rarely occurring imperative stimulus (20%). Latency of the late components of the ERP elicited both by target and standard imperative stimuli was significantly delayed in three alcoholic groups compared to the controls. The amplitude of P200 and P300 components was also decreased in alcoholics, which displayed the same middle line scalp distribution of P300 amplitudes regardless of the imperative stimulus class: target or standard. These findings agree with the supposition that match/mismatch processes are impaired in subjects with chronic palm alcohol intoxication, and that they have difficulties in evaluating the significance of stimuli.

Waking electroencephalograms in the blood-lymph and encephalitic stages of gambian trypanosomiasis.

Waking electroencephalograms (EEG) were recorded from 48 patients infected with Trypanosoma gambiense. The EEG of the 10 patients with blood-lymph involvement were indistinguishable from those of healthy controls but recordings from the 38 patients with the encephalitic phase of the disease showed three unusual profiles. One profile type, apparently indicative of early cerebral impairment, had a sustained low-voltage background similar to that seen during light sleep. A second profile type, seen in cases with acute cerebral involvement but without focal seizures, showed paroxystic waves. The third unusual EEG pattern was of various types of delta wave (similar to those seen in demyelinating encephalitis) and rapid, intermittent high-voltage delta bursts between periods of lower-voltage delta activity (as often seen in meningo-encephalitis); all types of delta wave were of higher voltage than the spike and wave complexes. Although no definite correlation has been established between the severity of the disease, the results of clinical tests, and waking EEG patterns, it appears that the three types of EEG profile are indicative of the degree of cerebral involvement.

[The risk of extra-colonic extension in Crohn's colitis]. / Le risque d'extension extra-colique au cours de la colite de Crohn.

One hundred and two patients with Crohn's colitis present on average for 8 years, were studied retrospectively in order to determine whether or not a group of patients existed in whom the disease remained limited to the colon, and if such a group could be identified early on in the course of the disorder. At the time of the diagnosis of Crohn's disease, 34 patients had a concomitant anoperineal lesion, while 68 had disease affecting the colon only. In the latter, at the end of the follow-up period, the disease remained exclusively limited to the colon in 39 cases (57 p. cent). The actuarial rate of non-extra-colonic spread was 75, 40 and 35 p. cent at 5, 10 and 15 years respectively. Spread involved above all the anoperineal region (55 p. cent at 10 years), and less often the ileum (20 p. cent at 10 years). In patients monitored for at least 6 years, there was no significant difference between those in whom disease had spread and those in whom it remained limited to the colon, regarding the main initial clinical findings by history and examination, the same applying after the disease had been present for 3 years. These results would go against the existence of a specific entity of "Crohn's disease affecting the colon as an organ" and support the opinion that coloproctectomy with a pouch should be avoided in colitis due to Crohn's disease.

[Electroencephalogram changes and psychopathologic disorders in 60 cases of chronic palm brandy intoxication (Ivory Coast)]. / Modifications de l'électroencéphalogramme et troubles psychopathologiques dans 60 cas d'intoxication chronique à l'eau-de-vie de palme (Côt e d'Ivoire).

The aim of the study was to assess the effects of chronic palm alcohol (a compound of ethyl and methyl alcohols distilled from palm tree wine) consumption, on waking electroencephalogram (EEG) of 60 alcoholics of both sexes. Four profiles have been determined on EEG abnormalities criteria: 1/ theta rhythms (44 patients), 2/ slow alpha rhythms (9 patients), 3/ slow waves and 4/ paroxysmal rhythms. The whole results are globally in agreement with reports regarding waking EEG abnormalities in ethylic subjects. Nevertheless the presence of thêta waves in recordings of many of the subjects, all irritable or aggressive and exhibiting emotional disturbances, would constitute the sign of this alcoholic type.

[Electroencephalographic study of trypanosomes in meningoencephalitic stage of human African trypanosomiasis from Trypanosoma brucei gambiense before and after treatment with DL-alphadifluoromethyl- ornithine hydrochloride monohydrate (DFMO)]. / Etude électroencéphalographique chez des trypanosomés en phase méningoencéphalitique de la trypanosomiase humaine africaine a Trypanosoma brucei gambiense avant et après un traitement à la DL-alphadifluorométhylornithine hydrochloride monohydratée (DFMO).

The aim of the study was to assess effects of DFMO (an inhibitor of polyamine biosynthesis) on waking electroencephalogram (EEG) of 25 patients at meningoencephalitic stage of human african gambiense trypanosomiasis (HAT), six of whom having been previously treated with and considered refractory to Melarsoprol. DFMO was administered intravenously at dose of 400 mg/kg/day for 14 days, followed by oral treatment at dose of 300 mg/kg/day for 21 days. EEG data were performed before, then 15 days after the end of the therapy. Initially tracings presented diversified abnormalities which have been classified into four groups: intermittent delta waves/generalised delta waves/low voltage background/paroxistic activities. Control recordings showed an improvement, but as for Melarsoprol tracings not returned completely to normal patterns. In most of the patients therapy was associated with clinical disorders improvement and in all but one with disappearance of trypanosomes. Marked amelioration in recordings of the patient who presented trypanosomes in LCR samples, suggest he was responsive to the treatment and perhaps therapy did necessitate continuation? The use of EEG investigation during treatments as a supervision way of patients with trypanosomiasis is discussed.

[Electroencephalographic study of meningoencephalitis from Trypanosoma gambiense before and after treatment with melarsoprol]. / Etude électroencéphalographique de la méningoencéphalite à Tripanosoma gambiense avant et après traitement au mélarsoprol.

The purpose of the study was to assess the long-term effects of melarsoprol on awakening electroencephalogram (EEG) in 18 patients at the meningo-encephalic stage of human African gambiense trypanosomiasis. Electroencephalographic data were taken prior to then 1 and 3 months after therapy. Before treatment EEG tracings showed important abnormalities (delta bursts organized in a more or less periodic fashion); 1 and 3 months after treatment a clear improvement was observed in 10 patients; however, it was unusual that the EEG completely returned to the normal pattern and a case of relapse was noted 3 months after the end of therapy. As indicated by persistence of the EEG abnormalities, several patients were unresponsive and one of them reacted negatively to melarsoprol. The use of regular EEG investigations as a means of long-term supervision of patients with trypanosomiasis is discussed.

Combined effects of methanol and ethanol on event-related potentials in non alcohol dependent men.

The effects of consumption of the beverage got by distillation of Elaeis quineensis on brain functions were investigated in ten healthy, non-alcoholic men. Each subject ingested 979 mg ethanol and 21 mg methanol/kg body weight. N1, P2 and P3 components of the event-related potentials (ERP's) were recorded during a go/no go task before, 60 and 240 min. after alcohol ingestion. Subjects were presented paired auditory stimuli--standard (60%) and target stimuli in a random order and were asked to detect and signal the target unconditional stimulus by pressing a push button. In the trials 60 min. after alcohol P3 was smaller than control, both N1 and P2 were flatter 240 min. after dosing, whereas P3 amplitude was not changed then. The results are consistent with ERP's changes in chronic alcoholics and suggest that a low dose of methyl alcohol may increase ethanol effects in non alcohol-dependent man.

Effects of Mel B arsobal and alpha-difluoromethylornithine on the awakening electroencephalogram of humans with gambiense trypanosomiasis disease: preliminary report.

Five males and three females, at the encephalic stage of sleeping sickness, were submitted to trypanocide therapies. Three of the patients were treated with the Mel B Arsobal drug, the five others with difluoromethylornithine, using different protocols. Awakening electroencephalographic data were obtained prior to treatment and, at regular intervals, during and after treatment. Prior to treatment the awakening tracings showed important abnormalities (slow delta waves were superimposed on theta background rhythms). During treatment (except in one patient treated with Arsobal) recordings returned gradually to fast rhythms and several days after therapy, tracings returned to the normal awakening patterns. The use of the awakening electroencephalogram as a tool to test effects of curative drugs in the sleeping sickness syndrome is discussed.

Auditory event-related potentials and reaction times during simple sensorymotor tasks in subjects with sickle cell disease and related hemoglobinopathies.

40 subjects of both sexes assigned to five groups of 8: healthy students, homozygous sicklemics, hemoglobin SC sicklemics, sickle cell Bo thalassemics, and sickle cell B+ thalassemics were subjected to 1/simple auditory stimuli; 2/paired auditory stimuli. The subjects were asked to respond quickly, by pressing a push button on detection of the simple stimulus or the unconditional stimulus of paired stimuli. A subsequent increase in reaction times and a reduction in event-related potential component amplitudes were obvious in major (SS and SC) sicklemics compared to controls and sickle cell B thalassemics. Between simple and paired auditory conditions, reaction times were more increased in sicklemics than in controls. These findings suggest that impairment of attentiveness, performance and cognitive capability in sicklemics is a function of sickle cell anemia severity.

[Apple II E microcomputer analysis of potentials related to an event: preliminary applications in West Africa]. / Analyse micro-informatisée sur Apple II E des potentiels liés à l'événement: premières applications en Afrique de l'Ouest.

An Apple II E micro computer program developed for clinical studies of event. Related potentials is described in this report. The capacities, limits, future developments and uses for clinical investigations in west Africa of this computer system are discussed.

Information processing to rare and frequent warning stimuli in a C.N.V. paradigm.

Seven normal young men were submitted to standard and target paired auditory stimuli. The warning stimulus of paired tones informed subjects whether or not the impending unconditional stimulus implied a motor response. Subjects were instructed to execute the motor response at less one second after the unconditional stimulus occurrence, and were informed that the standard warning stimulus was always followed by an additional stimulus which confirmed its detection. Components of target warning and imperative stimuli responses presented a significant increase in amplitude with regard to evoked potential components elicited by standard warning and unconditional tones. P3 waves observed in response to standard warning and unconditional stimuli culminated over fronto-central cortex, while P3 of target warning and imperative tone responses peaked over centro-parietal cortex. These results suggest that manipulating warning stimulus significance by assigning to it a discriminative function, can modify processing of the information carried out by paired stimuli.

[Cortical reactivity during reaction time tests in sprinters]. / Réactivité corticale au cours d'épreuves de temps de réaction chez les sprinters.

Thirty-two male subjects divided into 4 groups (of 8--controls, witnesses, students in physical and athletic education (PAE) and sprinters--were submitted to 1) simple auditory stimuli, 2) paired auditory stimuli, and 3) simple and paired auditory stimuli. The subjects, except the control group, have been assigned the task of quickly responding by pressing a button, accordingly the detection of the simple stimulus, of the imperative stimulus when the stimuli are paired, or the simple and imperative stimuli when they are randomly matched. The results show that the amplitude of the event-related potential components and of the CNV is significantly more important in sprinters and PEA students than in other groups. The differences indicate a greater adaptative reactivity of attentional mechanisms in athletes. In all the groups, the variations in the event-related potentials and of the CNV, as well as the variations of RT between conditions 1 and 2, indicate that the effects of activation and preparation differ depending on whether or not the signal for execution of the motor response is preceded by a preparatory signal. The decrease in event-related potentials and CNV amplitude and the elongation of RT in divided attention condition suggest that when subjects have to distinguish, at the same time, simple and paired auditory stimuli, interferences are induced. The attention is disturbed performance are impaired. Sprinters are less susceptible to interferences than control persons, their performances remaining significantly better.