[Case study of 199 patients with multiple sclerosis: the use of EDMUS program]. / Etude descriptive de 199 patients atteints de sclérose en plaques à partir du programme EDMUS.

European Database Multiple Sclerosis (EDMUS) is a standardized tool which allows the collection of clinical, biological, radiological and therapeutic data on multiple sclerosis (MS). A descriptive analysis of 199 patients was done using EDMUS (version 2.2). Most data agreed with previous published results, except a low 0.4 sex ratio. At the beginning of MS, 42 p. 100 of MS patients developed pyramidal and sensory involvements and 14 p. 100 retrobulbar optic neuritis. Optic neuritis was the most frequent initial symptom of relapsing-remitting MS (25.9 p. 100) but not in the chronic progressive form (5.5 p, 100; p < 0.01). Surprisingly, relapsing-remitting form occurred more frequently whereas the secondary progressive form was diagnosed less. The concordances between the three disability scales, EGS (EDMUS Grading Scale), EDSS (Expanded Disability Status Score) and AI (Hauser Ambulation Index) were correct. In clinical practice, EDMUS is user-friendly and rapid. The lack of radiological data and the necessary quantification of only one disability scale, EGS may be too restrictive. The analysis of most of clinical data is possible by using integrated selection within the software, but sometimes needs more complex procedures.

Diagnostic value of antithrombin III and aminopyrine breath test in liver disease.

To assess the value of the aminopyrine breath test (ABT) and antithrombin III (AT III) determinations in liver disease, both tests were performed on 77 consecutive patients who underwent liver biopsies for increased values of liver enzymes and in 20 patients with clinical cirrhosis. The mean values of AT III and ABT were significantly lower in cases of liver cirrhosis than in cases of steatosis and steatofibrosis. The AT III and ABT values were abnormal in, respectively, 83.9% (26/31) and 90.3% (28/31) of the patients with cirrhosis and 22.7% (15/66) and 28.8% (19/66) of the patients without cirrhosis. The association of the two tests increased the specificity without modifying the sensitivity. Both the AT III test and the ABT can be used as noninvasive diagnostic procedures for cirrhosis in patients for whom the liver biopsy is not available or contraindicated.