[A recount of an ethic commission meeting ].
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Biomedical subjects
Publications and source records attributed to J Epiney.
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After reviewing the epidemiological data of mortality and morbidity of pneumonia in old people, the various mechanisms of respiratory tract infections are described. This approach points out the very important problem of nosocomial pulmonary infections. The clinical diagnosis is not easy in this high risk population whose reactions to infection are usually weak and atypical. For multiple reasons, the bacteriological proof of the infectious disease in old age is very difficult to obtain, and the adapted antibiotherapy is uncertain. The choice of the medication will also have to be based on the modified pharmacokinetics for old people. Empiric considerations are very usefull as well as the discovery of new antibiotics, but above all, it is most important not to forget the possible immunization.
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10 patients with active symptomatic Paget's disease of bone have been treated for 6 months with disodium etidronate (EHDP) at a dose of 20 mg/kg/day. A statistically significant fall in the serum levels of alkaline phosphatase and urinary hydroxyproline was observed. However, only 2 patients experienced a significant reduction of bone pain. 6 patients were partially improved and 2 patients showed no change. Iliac crest biopsies after treatment demonstrated dimunution of the abnormal structure of the pagetic bone, but also a considerable increase in unmineralized osteoid borders. The future potentialities for treatment of Paget's disease are discussed.
Amongst 66 pagetic patients, whose average age (median) was 76 years, 9 cases of ACC were found. This represents an incidence of 13.6% of the whole group. Of 72 control subjects, whose average age (median) was 73 years, 7 were found to have ACC. This represents an overall incidence of 9.7% of the control group, but the difference is not statistically significant. From this study we conclude that ACC does not occur more frequently in Paget's disease than in a group of control subjects with the same age distribution.
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