[The general-duty nurse: current concepts of care].
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Biomedical subjects
Publications and source records attributed to J Richard.
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The assessment of total cholesterol level as a risk factor for cancer mortality was studied from data of the Paris Prospective Study of Coronary Heart Disease. A total of 7603 French male government employees aged 43-52 years were followed for an average of 6.6 years. One hunderd and thirty-four cancer deaths were registered with a mean survival time of 4.9 +/- 2.9 years. At entry in the study, future cancer cases were older than survivors and had a lower corpulence index and lower cholesterol value (212 vs 223 mg/100 ml, SD = 43 mg/100 ml) than those of survivors. The intitial cholesterol level did not differ significantly among cancer sites. The mean cholesterol value increased steadily with survival time (p < 0.02) and reached the mean survivors level in men with survival time longer than seven years. Longitudinal cholesterol measurements obtained among 81% of future cancer cases showed a mean decrease, after an average of 3.0 years, comparable to the one estimated from croos-sectional data. The association between low cholesterol and cancer mortality during a period up to seven years before death is not likely to represent an etiologic link but in all probability reflects the advance of the clinical course of cancer.
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The present observation concerns a female patient with a 47,XX, r(18), + mar karyotype. The size of the ring varies from mitosis to mitosis; generally it is very small. The presence of a small marker ("minute") may explain some phenotypic differences not usually observed in the "r(18) syndrome". This patient is the niece of a trisomic 21, who showed complex chromosome anomalies during the course of an acute leukemia from which he died.
Fifty patients with primary epidermoid carcinomas of the nasal sinuses were treated by intra-arterial chemotherapy, alone (2 fatal iatrogenic accidents occurred) or in association with surgery and/or radiotherapy (48 cases). Adverse reactions due to chemotherapy were noted in 11 patients (22%), and two of these were fatal (4%). In eleven patients (22%) the initial curative chemotherapy was unsuccessful and all died after a mean survival period of 12 months. Local recurrence was observed in 7 patients (14%), the mean survival period being 11,5 months, and in 6 patients (12%) with local glandular involvement the mean period was 15 months. Identical survival rates of 57% after 3 years (8/14) and 50% after 5 years (6/12) were observed in 14 cases with endosinusal forms and 14 patients in whom the infrastructures were treated. In 22 patients there was exteriorization of the lesion, and the survival rate was 31% after 3 years (7/22) and 15% after 5 years (3/19). All 7 patients with pterygomaxillary lesions died within 3 years. Overall results in the 50 patients treated show that: -- 23/50 (46%) survived for 3 years -- 15/43 (35%) for 5 years -- 5/19 (26%) for 10 years.
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Three cases of lymphoepitheliomas of the larynx are reported. This type of carcinoma--which occurs almost exclusively in nasopharynx--is very unfrequent in the larynx (0.2%). In the 3 cases, the tumors arose in a ventricular diverticulum which presented the same lymphoepithelial structure as the tonsils. Under such conditions, these lymphoepitheliomas, which have to be called 'undifferentiated carcinomas of nasopharyngeal type' are believed to develop from the lymphoepithelial tissue of the laryngocele.
116 patients consisting of 54 males and 62 females, all engaged in agriculture were interviewed to find out the cause of their unemployment. Deformity seemed to be the major factor responsible for the loss of job among them, which was prevalent among advanced age group (Males--50, Females--53.5). Since the measures to rehabilitate them are rather difficult, it is essential to educate them on the methods of prevention of deformities and their importance. If not, they invariably loose their job at an age when they cannot train themselves for a suitable alternative job to earn their livelihood.
In two different studies, the relation between plasma concentrations of acenocoumarol and apparent prothrombin levels (Quick test) was investigated, using a new specific analytical method for the assay of the drug. The prothrombin level appeared independent of the plasma concentration of the drug, which is higher in old patients (over 70 years) than in younger patients (under 51 years).
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Acenocoumarol, to which a 14C-labeled internal standard has been added, is extracted at pH 4 into ethyl acetate-heptane (20:80 v/v), back-extracted into aqueous sodium hydroxide solution after solvent washing with a pH 7 buffer, and reextracted after acidification in the solvent mixture. It is then acetylated with 3H-acetic anhydride. The acenocoumarol acetyl derivative is separated from the metabolite derivatives by TLC, and its radioactivity is measured. The method is specific and sensitive to a concentration of 8 ng/ml.
At the Bel-Air Psychiatric Clinic, Geneva, Switzerland, the technique of ultrasonic Doppler flowmetry was used to examine the internal carotid arteries of 30 aged patients - 10 with cerebral degenerative dementia, 10 with cerebrovascular dementia, and 10 without dementia. An index of cerebrovascular resistance was calculated. Apparently this index can distinguish a group of vascular dementias from a group of degenerative dementias.
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