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We report three personal cases of hydrocarbide aspiration pneumonia. High-viscosity non-volatile hydrocarbides (paraffin oil, for instance) cause often pseudotumoral exogenous fat-aspiration lung disease. Low-viscosity volatile hydrocarbides (petroleum, gasoline, white spirit, for instance) cause acute pseudo-infectious lung disease with dyspnea and fever which usually resolves within a few weeks but which may also be life-threatening. Purely symptomatic treatment has greatly progressed with advances in intensive ventilatory assistance. Gastric emptying with emetic agents or lavage procedures is dangerous and must be avoided except for exceptional cases. When required, the airways must be protected with tracheal intubation. Volatile hydrocarbides should be stored in protected areas in containers with safety stoppers which children cannot open.

The concept of addiction has gained recognition in French semantics, standing for a pathological condition that was formerly designated solely on the basis of specific drug abuse. We questioned 90 patients followed at there Parisian outpatient units about their understanding of the term "addiction". We also looked for signs that this term is used to federate notions since it is supposed to describe a general condition involving a large number of singular phenomena. One part of our questionnaire focused on treatment modes (several practitioners for several addictions, one institution for all addictions, specialized consultations with a practitioner other than the usual primary care physician). Our findings would illustrated areas where further details are needed in order to consider patient expectations when designing specialized care for outpatients or inpatients.

Sixteen patients with Churg-Strauss syndrome (CSS), a disorder characterized by hypereosinophilia and systemic vasculities which complicate preexisting asthma, were analyzed. The mean duration of asthma before CSS was 8 years; peripheral blood eosinophilia was always greater than 1,900/microliters and exceeded 5,000/microliters in 14 cases. The clinical manifestations were the following: 16 in generally poor condition with fever; 12 peripheral neuropathies; 11 cutaneous lesions; 9 pericardial or myocardial involvement; 9 digestive disorders; 9 muscular or articular diseases; 5 renal involvement, all associated with the vasculitis; 7 upper respiratory tract disorders. Chest radiographs showed pleuropulmonary or cardiac anomalies in 11 patients. The diagnosis was confirmed histologically in 11 cases, however, no clinical, biological or evolutive differences were observed between these patients and those with negative biopsies (5). Follow-up for 6.35 +/- 5.55 years was characterized by relapses always preceded by increased eosinophilia. Fourteen patients were successfully treated with corticosteroids, associated with cyclophosphamide in 7 of them. Five-year survival was 87%. Four deaths occurred, all CSS-associated, two because of a poorly adapted therapeutic regimen. The need for rapid and effective treatment must be stressed. The diagnosis can be made based on clinical manifestations alone before histological confirmation can be obtained.

We determined the relative value of the free erythrocyte protoporphyrin (FEP) assay compared to those of total iron-binding capacity (TIBC) and serum ferritin in the diagnosis of iron deficiency in a population of elderly anemic subjects. One hundred and three patients, 65 to 98 years old (mean +/- SD: 81.5 +/- 8.8), with hemoglobin levels of less than 110 milligrams (mean +/- SD: 97 +/- 12, range 53-109) were included in the study. In the patients with iron-deficiency anemia due solely to chronic bleeding, mean values for the three parameters were highly different from those in patients without chronic bleeding. In the patients with anemia due to an association of chronic bleeding and chronic inflammation, the mean FEP value was very significantly different (p less than 0.001) from that in the patients with chronic inflammation but without bleeding, whereas this was not the case for TIBC or serum ferritin. The sensitivity of FEP in the diagnosis of iron deficiency due to chronic bleeding in this population of anemic subjects was 60% (specificity 90%), compared to 13% (specificity 96%) for TIBC and 20% (specificity 100%) for serum ferritin. The FEP assay thus emerges as being highly suitable for the diagnosis of iron-deficiency anemia in the elderly subject, particularly when bone marrow is not examined.

In the first National Health and Nutrition Examination Survey (NHANES I) there were 3,479 persons aged 65-74 years corresponding to 12,773,000 in this age group in the total population. Presented here are major findings on the nutritional status of this age group in respect to 1) dietary intake (based on a 24-hour recall) and dietary frequency, 2) selected biochemical and hematological tests, 3) prevalences of clinical signs associated with deficiencies of nine essential nutrients, and 4) selected anthropometric measurements. These findings will be presented by sex, two racial groups (black and white), and two income groups (poverty index ratio (PIR) below and above unity). Some correlations between clinical signs and dietary intake comparing persons with signs and those without signs are shown. Some trends between dietary intake and biochemical values, on the one hand, and biochemical values and clinical signs, on the other hand, will be touched upon. The findings are discussed in relation to dietary adequacy and nutritional risk of the different subgroups. Some paradoxical results are discussed and the need for urgent research on the so-called secondary or conditioned deficiencies specifically in this age group are pointed out.

The hour of day of primary ventricular tachycardia (VT) in the acute phase of myocardial infarction was studied in 63 consecutive patients without cardiac failure or antiarrhythmic therapy, admitted to hospital less than 6 hours after the onset of chest pain. There were 19 women and 44 men, with an average age of 63 years. The site of infarction was anterior in 23 cases, posterior in 34 cases and circumferential in 6 cases. The cardiac rhythm was analysed from the 6th hour following the onset of chest pain for 4 days, using a HP 98220 A computerised analyser CPK levels were measured daily. Ventricular tachycardia occurred in 73% of cases with no significant difference between daytime (18 patients) and night time (28 patients). The patients developing VT did not differ from the remainder with respect to age, sex, or site of ECG changes, but peak CPK levels were significantly higher than in patients without VT. The risk of VT decreased slowly as the interval from the onset of chest pain increased and fell practically to zero after the 40th hour. Diurnal and nocturnal VT were independent of age, sex or site of infarct. However, nocturnal VT correlated independently of the time of onset of chest pain to high values of CPK. There was no difference with respect to age, sex, location of infarct or incidence of ventricular tachycardia between infarcts with pain starting during the day, and infarcts with pain starting at night. However, when the pain started during the day, the peak CPK was significantly higher and there were significantly more attacks of nocturnal ventricular tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS)

Eight percent of Negroes between the ages of 45 to 59 had hepatomegaly. Tongue signs and absent knee and ankle jerks were more prevalent in Negroes ages 45 to 74; they also had lower urinary excretion of thiamine and riboflavin than Whites. Bowed legs and knock knees were more frequent in Negroes ages 1 to 17 and Negro women 18 to 44. Prevalence of bleeding, swollen gums was highest in Negroes ages 45 to 59. Both grade I and II goiter were more prevalent in Negroes at all ages except men 18 to 59. Chvostek's sign indicating possible calcium deficiency was more frequent in Negroes at all ages with two exceptions. Major anthropometric findings will also be presented.

Numerous abdominal manifestations were noted among 600 patients undergoing treatment at Hospital Laennec for various stages of infection by the acquired immunodeficiency virus. These included violent abdominal pain in 30% of cases, the development of abdominal lymphoma, and occasionally alarming pseudo-surgical syndromes. Diagnosis is difficult, all the more so since authentic emergencies may be aggravated by the immunodeficiency state. 18 cases were collected in 3 years and included 6 cases of acute cholecystitis and 2 of appendicitis. The gangrenous and extensive nature of infection was generally noted and required appropriate antibiotic therapy.

Some of the major findings from the First Health and Nutrition Examination Survey in the United States were presented related to the Nutritional Status of the American people. These findings cover a range from possible deficiencies to possible escesses. Among the deficiencies, iron is the most frequent, affecting particularly young children and women of childbearing age as reflected by relatively low intakes and relatively high prevalences of low hemoglobin values and percent transferrin saturations. Mean hemoglobin values of blacks were significantly lower than those of whites in spite of higher iron intakes in many black females. Low mean intakes of calcium in black women were found associated with higher prevalences of Chvostek's sign, and low mean vitamin A intakes in younger black men and women of all ages were associated with follicular hyperkeratosis. On the excess side of the range were total fat, saturated fat and cholesterol intakes which are among the highest known. These high intakes are associated with relatively high serum cholesterol levels and a high frequency of obesity. Obesity in white women aged 20-45 years was associated with a lower reported caloric intake and a lower exercise score.

Cough is a well recognised though undesirable side effect during the course of treatment with angiotensin converting enzyme inhibitors (IEC). With the help of two examples we have tried to show that this cough does not have an immunological origin but rather pharmacological. Cough was suppressed by non steroidal anti-inflammatory drugs. Stemming from these observations and from two studies in the literature a patho-physiological mechanism for the cough is proposed in which treatment with IEC leads to a connection with prostaglandins, notably bronchial PGE2.

Mean serum magnesium values with one standard deviation are presented for 224 women during pregnancy and 1559 women taking birth control pills, with 4145 women, aged 15-49 years, as controls. In addition, similar data are presented for 2,884 women, aged 50-74 years, after menopause. All these women were surveyed in the first National Health and Nutrition Examination Survey in the United States of America, 1971-1974 (NHANES I). Information on use of birth control pills is based on two questions taken from the NHANES I medical history interview. Pregnant women had significantly lower serum magnesium values than controls (nonpregnant and no birth control pills), regardless of age or race. Women on the pill also showed significantly lower serum magnesium values than other nonpregnant women of similar age, but the differences were much smaller than those between pregnant women and controls. Women older than 50 years (postmenopausal women) had significantly higher serum magnesium values than premenopausal women. These findings are compared with similar findings from other studies in the United States and other parts of the world.

Serum magnesium has been determined by atomic absorption spectrophotometry in a national sample of the United States population between 1971 and 1974. Mean values and percentile distributions are presented for ages 1-74 in males and females in two racial groups. Mean values decreased in both sexes from age 1 to ages 12-24. In females, they increased again after age 25, while males showed little change after age 17. Small sex differences were observed between ages 18 and 45, with men having higher levels than women. Both white males and females had higher serum levels than black males and females of the same age. These differences were statistically significant in many age groups, particularly in young and middle-aged adults. These data are unique inasmuch as they represent the only broad population measurements of serum magnesium in the United States. No comparable data exist as far as is known. The values shown can be considered as normative for the U.S. population. A review of the literature with comparable data was done and results are included; a discussion of the findings from these studies is presented.

Analyzing data from some 8,000 adults in the United States reveals that adult diabetes is highly associated with age but not with sex. Older adults are more likely to have diabetes than younger adults. For younger adults diabetes is associated with body mass and blood pressure but not with physical activity level. Those who are above the median in body mass or who are hypertensive have higher risks of being afflicted with diabetes than those who are below the median in body mass or who are normotensive. For older adults diabetes is not associated with blood pressure but is highly associated with physical activity level and a measure of body mass based on maximum reported weight. Those who are lighter or who are physically active are much less likely to be diabetic than those who are heavier or who are physically inactive. We further found that for these adults the association between physical activity level and diabetes is independent of body mass. The epidemiological evidence strongly supports the conventional wisdom of dealing with diabetes by reducing body weight, lowering blood pressure, and particularly for older adults, engaging in some kind of regular physical activity.