Baudouin Maldague

Long-term effects of localized spinal radiation therapy on vertebral fractures and focal lesions appearance in patients with multiple myeloma.

The occurrence of new vertebral fractures and focal marrow lesions was determined and compared in irradiated and nonirradiated vertebrae of 12 patients with multiple myeloma (MM), prospectively followed using magnetic resonance imaging (MRI) of the thoraco‐lumbar spine after localized spinal radiation therapy. During follow‐up (mean 35 months), fractures appeared in 5% of irradiated vertebrae and in 20% of nonirradiated vertebrae; new focal lesions appeared in 4% of irradiated vertebrae and in 27% of nonirradiated vertebrae. This study demonstrates a beneficial long‐term effect of localized radiation therapy, consisting of a reduced incidence of vertebral fractures and focal marrow lesions in irradiated vertebrae.

Paget9s disease of bone.

were corrected in three days by intravenous perfusions of saline solutions, without nasal oxygen therapy or artificial ventilation. The treatment of metabolic alkalosis is based on the correction of hypovolaemia by perfusions of chloride-containing solutions, since hypochloraemia maintains metabolic alkalosis. The spontaneous ventilatory compensation of metabolic alkalosis in these patients suggests that the respiratory centre depression produced in severe alkalosis predominates over the stimulatory effects of hypercapnia and hypoxia. By recognition of such hypercapnia as a life-saving response unjustified artificial ventilation may be avoided. T CONSTANS J L GUILMOT Clinique Medicale A P CHEVALLIER D PERROTIN