Evaluation of renal function in 60 long-term survivors of bone marrow transplantation.

Although the acute nephrotoxicity of bone marrow transplantation is well documented, long-term follow-up studies are scanty. Renal function was evaluated in 60 long-term survivors of allogeneic (24 patients) or autologous (36 patients) bone marrow transplantation (BMT) with a mean follow-up of 2 yr. Renal function tests included serum creatinine, GFR (inulin clearance), effective RPF (p-aminohyppurate clearance), urinary beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase excretion, and renal tomography. The mean serum creatinine level was 83 +/- 3 and 93 +/- 3 mumol/L before and after grafting, respectively (P < 0.05). The mean GFR (93 +/- 3 mL/min) and effective RPF (419 +/- 16 mL/min) were significantly lower than in healthy controls (120 +/- 3 and 500 +/- 1 mL/min; P < 0.05) and than in candidates for BMT matched for age and hematologic diseases (117 +/- 3 and 469 +/- 11 mL/min; P < 0.05). Thirty-four patients had a fall in the GFR of at least 20%. Patients who received total body irradiation had significant lower creatinine clearance (86 +/- 3 mL/min) and GFR (86 +/- 3 mL/min) than the controls and the patients who received high-dose chemotherapy (100 +/- 4 and 104 +/- 5 mL/min; P < 0.05). These results suggest that subclinical renal dysfunction occurs frequently in marrow graft recipients, especially those who undergo total body irradiation.

[Epidemiology of depression (author's transl)]. / Epidémiologie de la dépression.

The authors use a number of recent studies to illustrate what can be achieved by exemplary work on depression. One of the studies is concerned with incidence in one community and others with comparisons of clinical and psycho-social aspects of depression in different cultures. They underscore the importance of making the distinction between conspicuous and hidden morbidity when measuring morbidity rates. In clinical practice, psychiatrists see only a narrow range of the depressive spectrum, which is made up of many different clinical entities varying in symptomatology and severity. Attempts to compare the prevalence of these conditions are often frustrated by problems of definition and classification of the clearly morbid states, in addition to the difficulties inherent in differentiation between these states and the normally accepted range of mood variations. These points are probably largely responsible for wide differences in the prevalence rates published by different authors and for different countries. The latter part of the discussion emphasizes the scientific importance of transcultural comparisons of depressive symptoms and points out the need to assess the influence of socio-cultural changes upon the frequency and types of depressive states. Throughout all this discussion, the necessity of standardized instruments of clinical assessment is underlined.

[An epidemiologic approach to psychoses]. / Une approche épidémiologique des psychoses.

This study is an epidemiological approach of psychoses based on morbidity statistics from french psyschiatric hospitals for the years 1968, 1971 and 1975. It compares some of the most interesting census and first admission data for the following categories: manic-depressive psychoses, chronic schizophrenia and paranoid states on the one hand, neurotic conditions, personality disorders and non-psychotic depressions on the other. Major trends are analysed. Two of them seem particularly interesting: 1) the decreasing number of cases classified as manic-depressive psychoses; 2) the diminishing proportion of females in most instances. Some explanatory hypotheses are suggested.