[Paroxysmal atrioventricular block due to anticholinesterase therapy]. / Troubles de la conduction auriculoventriculaire paroxystiques liés à la prise d'un anticholinestérasique.

The authors report a case of paroxysmal syncopal complete atrioventricular block due to anticholinesterase therapy occurring after the first administration. The block was reversible. It is therefore important to exclude this cause of atrioventricular block in the elderly in view of the increasing indications of this therapy.

Salicylate kinetics in old age.

Salicylate kinetics were determined in 28 subjects 25 to 92 years old who received single, oral doses of sodium salicylate (1 gm/1.73 m2). The serum AUCinfinity of total salicylate did not correlate with age. There was a weak positive correlation between the AUCinfinity of free (unbound) drug and age, but there was no apparent difference between the AUCinfinity values of the 15 women and 13 men. Seven of the 16 subjects greater than 70 years of age cleared salicylate at about the same rate as the younger subjects. A comparison of these seven subjects with the nine greater than 70 years old who were slow eliminators of salicylate revealed that the latter group consisted of more bedridden patients and that these patients had somewhat lower serum albumin concentrations, but they did not differ from the more rapid eliminators with respect to serum creatinine or urea nitrogen levels, SGOT, average age, female/male ratio, and average body weight. The serum protein binding of salicylate decreased with increasing age, apparently due mainly to decreasing serum albumin concentrations.

[Splenic arterial aneurysm rupturing into the splenic vein. A rare cause of acute fortal hypertension in the post-partum period (author's transl)]. / Anévrysme artériel splénique rompu dans la veine homologue. Une cause rare d'H.T.P. aiguë du "post-partum"

Following the sudden onset of a clinical syndrome of acute portal hypertension in a young woman in the course of childbirth, angiography revealed a voluminous aneurysm of the splenic artery rupture into the splenic vein. Surgical treatment was successful. The authors review the main characteristics of splenic arterio-venous fistulae and discuss the physiopathological problems of portal hypertension associated with such lesions.

[Complete parenteral alimentation after major digestive surgery using lEB 51-Trivé 1000]. / Alimentation parentérale compléte en chirurgie digestive majeure avec l'EB 51 - Trivé 1000

The aim of this work is to study the tolerance and the effectiveness of a complete intravenous feeding with EB 51 - Trivemil in immediate post-operative period, in 40 patients undergoing major digestive surgery. The patients were divided into three groups:--first group: 25 patients were given daily an average of 2900 calories 1500 of which via the Trivemil, during the first four post-operative days.--Second group: 5 patients received the same daily caloric dose but because of local complications, drips were maintained until the 7th day.--Third group: 10 patients received an average of 3100 calories daily 2000 of which via the Trivemil. The tolerance was evaluated by a clinical observation (blood pressure - nausea - cutaneous manifestations - temperature) and by a biological observation (hemolysis - free hemoglobin - plasma clearing). The use and effectiveness of the nutrient was evaluated - globally - by a study of body weight according to the hydro-electrolytic balance and then - individually - by the balance of the intakes and secretions of the glucides, lipids and proteids. The tolerance was excellent in all the cases, the weight remained stable, the nitrogen retention was constant mainly in the third group where it seemed to depend on the initial total energetic intake.