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In 1918-19 the so-called spanish influenza pandemic killed about 20 to 40 millions people all over the world. In France the loss of life was reckoned between 125,000 and 250,000 civilians and 30,000 soldiers though the epidemiological data have been incomplete. The virus allegedly came from the United States of America with the American forces which landed in the western harbours of France and probably with Indochina's troops or Chinese workers hired in the French factories. The disease spread in three waves from April 1918 to February 1919. The second wave was the most severe in September, October and November. Half of the dead occured among the 20-40 old people as the older people were more disease-resistant. Lethal forms were due to respiratory complications which often killed in a few days. The government did to preventive measures that were unequally applied as the treatment could be only symptomatic. The reactions of people were astonishingly cautions probably because the papers were ordered not to deal with the epidemic as long as the war lasted for.Some new serological studies and molecular biology techniques led up to clarify the strain of the 1918 influenza virus without further understanding of its special virulence.

Continuing education in dentistry is gaining importance. No dentist can nowadays claim to have obtained enough knowledge in studies and professional career alone to cope with new technologies and changing patient's demands. In many countries, discussions are ongoing or have taken place between protagonists and antagonists of a mandatory continuing education for dentists. This paper describes the regulations concerning continuing education in some European countries. In some countries, participation is mandatory, and more countries are planning to do so. In other countries, incentives exist, but in the majority, continuing education is still on a voluntary basis or regarded as a moral obligation.

This paper offers an analysis of the analogies between the physical and the political body during the Sixteenth and the Seventeenth centuries. Focusing on a meaningful pattern of medical, legal and political treatises, this study aims to outline the deep roots of an organic image of the human society widespread until the Englightenment and the crisis of the Old Regime.

Central venous catheters are widely used as vascular accesses for chronic haemodialysis. Different factors may lead to catheter use, whether clinical such as emergency dialysis, or related to practices specific to each dialysis unit or country. The Dialysis Outcomes and Practice Patterns Study is an observational study of more than 10,000 representative patients treated by haemodialysis followed over a two-year period in the United States, Japan, and in five European countries (France, Germany, Italy, Spain, United Kingdom). DOPPS data from the United States and Europe about catheters are reported in this paper. Catheter use is less frequent in Europe than in the US, both in incident and prevalent patients, and in patients who have been seen by a nephrologist in the pre-dialysis period. Tunneled and untunneled catheters are each associated with a significantly higher frequency of access infection compared to native arteriovenous fistulae and grafts. Patients with important comorbidities such as diabetes, cardiovascular diseases, malnutrition or dementia are more likely to be dialysed with tunneled catheters. Furthermore, patients initiating hemodialysis with a tunneled catheter display higher mortality risk compared to patients starting hemodialysis with a permanent access. In summary, DOPPS data indicate that central venous catheters are used for chronic haemodialysis in patients with a high level of morbidity, and that their utilisation is associated to an additional risk, particularly of infection, and to a lower survival for tunneled catheters. Appropriate care should limit the utilisation of central venous catheters to clinically undisputable indications.

Introduction: How can we explain that the proportion of methicillin-resistant Staphylococcus aureus (MRSA) varies between the European countries, ranging from < 1% in Scandinavia to > 30% in Spain, France and Italy? This paper is aimed at attempting to determine factors at the origin of the spreading of endemic MRSA strains as of the early 1980s. Those strains are characterized by their ability to develop resistance to current antibiotics and make treatment of severe and deep infections more complex., Current Knowledge and Key Points: Differences in the virulence of MRSA strains and that of susceptible strains appear unlikely. MRSA prevalence seems to be a growing problem, especially in Southern Europe where rates of resistance to other anti-staphylococcal antibiotics are high. General policies for antibiotic therapy as well as the implementation of strategies for prevention and control of MRSA might be responsible for such rates. Indeed, once MRSA is introduced into a facility without control program, this multiresistant bacteria rapidly spreads within the hospital and becomes endemic, expanding its reservoir. FUTURE PROSPECTS ET PROJECTS: Due to the introduction of new methods in microbiology and communication, infection control measures including procedures for isolation and identification of MRSA reservoirs are still feasible; however, their implementation requires human and material resources. Areas requiring improvement in the detection of MRSA outbreaks are identified in this paper, with particular emphasis on the need for national surveillance of MRSA prevalence and reappraisal of MRSA control strategies in French hospitals.

Introduction: The origins of the EAMA (European Academy for Medicine of Aging) course are described in this paper by the Scientific Committee of this new post-graduate teaching activity., Current Knowledge and Key Points: Innovations are constantly introduced to improve training methodology so as to enable the students to update their knowledge, help them improve their skills in data gathering and in the critical interpretation of information, and exchange geriatric experience and know-how. To reach such goals, an interactive teaching method is implemented by the professors, with world experts being called in to ensure scientific soundness and quality. Evaluations by students and teachers are regularly carried out with the aim of perfectly adjusting their training methodologies and increasing the scientific level of exchanges., Future Prospects and Projects: If the students progress, so do the teachers....

Emergency medicine has emerged as a specific medical specialty for 30 years. To be efficient, the emergency clinician frequently needs the contribution of radiological examinations. This is the reason why emergency radiology has emerged as a new radiologic subspecialty. The aim of this paper is to review the recent history of emergency medicine and to summarize the present state of the radiological organisation for emergency care in the Western countries.

The frequency of new cases of myelomeningocele has largely decreased in the last 10 years in several countries of western Europe; the emergence of widespread prenatal diagnosis is probably one of the main reasons. However, the outcome of spina bifida which eludes the prenatal diagnosis, or in cases where termination was refused by parents, remains badly known. To our knowledge, there is no recent data on the outcome of children with spina bifida. Moreover, available data, depending on their European or American origin, indicate different functional outcomes. This led us to re-evaluate the mechanisms involved in the prenatal diagnosis of spina bifida and the outcome of our patients with spina bifida. The aim of this paper is to give a short description of the "rules and principles" of prenatal diagnosis as it is applied in our centres, as well as a brief overview of the outcome of 137 cases of spina bifida. In the retrospective study, three major aspects were evaluated: 1) frequency and types of surgeries and their benefits; 2) socio-psychological adaptation of the patients; 3) educational level and learning disabilities.

This paper and the next, report on the experience of adolescent care in an ambulatory and multidisciplinary center based on a bifocal medical and psychological strategy. Two thirds of the adolescents are referred by a physician. The most common reasons are one or several somatic symptoms with a background of emotional complaints. Those reasons are consistent with the general adolescent health problems as revealed by studies of large national samples. It appears critical to read the adolescent complaint in a psychological register together with the somatic aspects. Initially, the adolescents are however rarely open for awareness of their psychological needs. This justifies care in a center where the initial medical management may secondarily result in psychological management.

The present paper surveys the discussions conducted by official statisticians regarding the ideal structure according to which a national data collection system should have been designed if it was to meet the challenges put up by the various transformation Western countries have undergone since the beginning of the 19th century. Arguments in favour of coordination, centralization, or decentralization have emerged for the first time in 1832 Britain, when the Statistical Bureau of the Board of Trade was created. Up to 1945, this debate went on, the industrial take-off, the economic crises, and the world wars all being occasions for its protagonists to put forward their preferred view. The perspective we take here is original in two respects: on the one hand, instead of confining ourselves to the major statistical systems (those of France, Britain, and the USA), we intend to evoke a large number of cases and, from this comparative standpoint, propose a general account of the drive towards centralization; on the other hand, instead of restraining our-selves to the 19th century, we cover the entire time-frame extending from 1800 to 1945.

The history of the word panic, of the concepts of Panic attack and of Panic Disorder is a complex one. The adjective word panic, derived from the Greek, stressed initially the intensity of a feeling of unjustified, individual or collective, fear, similar to the reaction provoked, according to the mythology, by the intervention of the God Pan. In their present meanings, the concepts belong to the group of anxiety states, the Panic attack being a symptom characterized by a paroxysmal anxiety which may appear in various psychopathological states, whereas the Panic Disorder is a nosological category whose diagnostic criterium is the appearance, with a definite frequency, of Panic attacks. The disorder is frequently associated to agoraphobia considered, when it exists, as a complication. It is necessary to describe, in addition to the terms and concepts related to panic, the history of the terms angoisse and anxiété (and of the equivalent ones in English and German, since many studies dealing with the subject have been written in those languages) and the history of agoraphobia. The history of the word panic and of the psychiatric concepts to which it is applied today are partially different as are the current meanings of the adjective and the substantive (and today of the verb to panic) from their technical meanings. In the technical vocabulary the substantive word refers on the one side to an abnormal group behaviour whose mechanisms, when it appears in an army by also elsewhere, are studied by social psychopathology. On the other side it has been used until recently, but only in psychiatric texts written in English, for describing acute individual states of high anxiety, eventually associated with other symptoms, and considered as pertaining-in contrast to the Panic attack in its present meaning-to various psychiatric illnesses (melancholic panic, homosexual panic). A description of states similar in their aspects, including the association to agoraphobia, to the present Panic attack, may be found in the literature of the XIXth century. Essential in this respect is the description of anxiety neurosis which Freud isolated in 1895 from neurasthenia and defined by the coexistence of a state of moderate and permanent anxiety and of anxiety attacks, whose manifestations were identical to those of the present Panic attack. Under the influence of Klein's researches which, from 1962 on, demonstrated the differential reactivity to drug therapy of its two component parts, anxiety neurosis was divided in two distinct entities. The term Panic attack-for reasons given in detail by the paper-was proposed for the acute anxiety attack, whereas the state of moderate and permanent anxiety, considered as a completely independent disorder, received the name of Generalized Anxiety Disorder. The concept, with its corresponding nomenclature, was adopted initially in the United States by the RDC (1975), then by the DSM-III (1980). It is accepted today and has been the source of a large number of investigations about its semiological, nosological, epidemiological, etio-pathogenic and therapeutic aspects which fall outside of the scope of this paper.

Recent papers about bovine spongiform encephalopathy (BSE) and new variant of Creutzfeldt-Jakob disease (nvCJD) are reviewed: new data, maternal transmission of BSE, epidemiology of BSE in British cattle, structure of the PrP(res), biochemical signature of PrP(res), chronic pesticide-initiated modification of the prion protein, protein markers in cerebrospinal fluid.

In the XVIII and XIXth centuries, a real morbid fear of premature burial raged all over Europe. Though this question is lost in the mists of time, the publication of Michael Ranft's book (1728) on the one hand, and the awarding of the Manni Prize to Eugène Bouchut (1849) on the other hand, are two key-dates, between which the amount of researches on the diagnosis of death show the need of reassuring answers to an anxious population. This paper summarizes the bibliography on premature burial, and its results on the diagnosis of death from 1728 till 1849.

The aim of this paper is to compare respiratory mortality, cancer and tuberculosis excluded, in 10 countries during 12 years. Mortality data came from World Health Statistics Annual of the WHO and age adjusted rates were calculated. For all causes respiratory mortality, acute pathologies and chronic obstructions not elsewhere classified, United Kingdom and above all Eire have the highest rates; Italy, France and Germany have the lowest rates; the other countries (Belgium, Denmark, Netherlands, Canada, United States) have rates similar, sometimes equal). For chronic conditions, Denmark has the highest rates, Canada and United States the lowest; Eire and United Kingdom begin a great decrease from 1983. On the whole, differences between countries do not vary very much with the years or the pathologies and the evolution over the time is not very marked apart from some countries.

Health care organizations similar to American HMOs have recently appeared in Switzerland. They elicit many reactions, both in the general public and among the medical profession. In contrast to traditional health insurance, HMOs organize and actively manage health care delivered to their members. This paper reviews the historical background of similar organizations in Europe and in the United States, and focuses in particular on the recent evolution and fragmentation of the concept of "managed care". Follows a discussion of the mechanisms and the side-effects of various tools used to manage care, both in managed care settings and by traditional health insurance plans. It appears that all of health care is managed, that all management tools have potential side effects, and that use of some management tools implies a redistribution of the respective roles of plan members, administrators, and physicians. The authors suggest that the complexity of health care management requires a more active implication of the health professions in that process.

During the year 1992, the main episodes of the battle of Normandy (1944) were commemorated with solemnity and dignity. The workmen of the victory, in what was called the greatest Battle of History, were essentially the American, British and Canadian troops. But, units composed of men from some European countries, particularly Frenchmen, Poles, Dutchmen and Belgians were also involved. Some of these units were engaged in action only at the beginning of August 1944, as soon as the whole peninsula of Cotentin, from Cael to Avranches, was firmly held by the Allied Forces and an offensive war through the Continent was considered. Apparently, the Allied Supreme Command had decided to preserve a reduced effective force of these units, during the most bloody phase of the battle for the conquest of a strong bridgehead. So they were kept in a position to participate in the liberation of their respective countries. In this paper, the author evokes a Belgian medical participation in the campaign of Normandy.

"This brief paper identifies the most important moments and the most significant studies of Italian historiography on emigration. These range from the first formulation of economic and national models of the Italian exodus to their subsequent fragmentation into a mosaic of regional and local historical and anthropological studies. Ultimately, this will allow a much needed conceptual synthesis, aiming at new comparative research objectives, and a less specialized and sectorial analysis of emigration. Such an approach would also help us to tackle the migrational phenomena in contemporary society with a greater historical awareness and with more adequate cultural comprehension." (SUMMARY IN ENG AND ITA AND SPA), (excerpt)

This paper aims to throw light on the controversial issue of A. von Haller's alleged "conversion" from epigenesis to preformation. This "conversion" is usually linked to the reaction of the Swiss scholar to the publication of Buffon's theory of generation (1749). A close study of the texts published by the author of the Physiology on this occasion reveals that, far from having adopted the theory of preformation, he continued to defend epigenesis in a moderate form, a view which was not so different from that held at the same time by Buffon's associate, J. T. Needham.

"This paper analyses available demographic data on international migration within and to Europe during the period 1918-1939 and 1945-1993. The main focus is on the east-west dimension of this migration. In the inter-war period some 9.2 million people either left their countries as labour migrants or were displaced.... In the post-war period (1945-1950) some 15.4 million people fled or were displaced within Europe.... Between 1950 and 1992 another 14 million people migrated from a country in East-central and Eastern Europe to the West.... In recent times the wars in Croatia and Bosnia as well as ethnic cleansing have led to the largest wave of refugees and displaced persons since 1945.... Our paper concludes that push and pull factors causing massive migration cannot only be contained by erecting new legislative barriers and deploying more armed border guards against newcomers." (SUMMARY IN ENG AND SPA), (excerpt)

Nowadays inflammation is commonly defined as a defensive reaction involving the immune system. This paper clarifies the historical roots of this definition. The Russian embryologist Metchnikoff made--100 years ago--the initial observations on phagocytosis that provided a definition of inflammation based on a cellular theory of immunity. Following the many attacks by those who favored the view that immunity was based upon humoral mechanisms, Bordet argued that Metchnikoff's cellular theory of inflammation could be reconciled with the theory of humoral immunity. This study helps the modern reader to grasp the theoretical assumptions supporting our concept of inflammation.

This paper summarizes the research activities and the actions conducted and implemented by the author during the past 30 years in the field of the disorders induced by iodine deficiency and by neonatal hypothyroidism. This work was conducted within the framework of the activities of the author in the Department of Pediatrics in Saint-Pierre Hospital. The work resulted in original contributions to epidemiology, etiopathogenesis, clinical manifestations, diagnostic procedures, complications, prevention and therapy of the disorders resulting from iodine deficiency or neonatal hypothyroidism. Special attention was devoted to the prevention of impairment of brain and intellectual development resulting from both conditions in the infant.

"The purpose of this paper is to present evidence for a long term link between employment and population [in rural France]. A model is built in order to describe the interaction between employment, migration and natural population increase over 1962-1990. This shows how declining departments are bound within a vicious mechanism: while the decline of local employment leads to population outflow, the population decline contributes to a further employment fall." (SUMMARY IN ENG), (excerpt)

Radon is a natural radioactive gas, with worldwide distribution, deriving from uranium decay products, which can be inhaled, weather in mining condition (extraction and management of uranium ores) or in domestic condition (in some high risk homes or geographic areas). The main epidemiologic studies on uranium mining workers have all confirmed an excess in relative risk of primary lung cancer. Epidemiologic studies on indoor exposure suggest a role of radon in the genesis of a certain number of primary lung cancer, although these results remain controversial and need to be confirmed. An overview of the main actual problems related to this bronchial carcinogen is presented in this paper.

Season of birth may influence considerably children's survival. This study extends the analysis that the authors have already carried out on the Italian regions and Savoy to other countries: Russia, Low Countries, Belgium and Switzerland. The data refer to the second half of the 19th century. It is in Italy that differential mortality according to season of birth is larger (maximum differential in the Venetia region), followed by Russia and Switzerland. Climate's influence (cold in winter and heat in the summer) combine its effects with social customs typical of each country, age and weaning, other customs concerning children's survival. These different combinations determine some unexpected results in the various countries. In the final part of the paper, data derived from family reconstitution of two Tuscan villages (1790-1916) are analysed in order to build a simple model measuring the net impact of climate on mortality during the first two years of life.

This paper gives an account of the new orientations in history of Medicine, of its opening up, and of the new pluridisciplinary approach it intrinsically requires. It examines the past of the history of Medicine. This discipline, born during the 18th century, was at the beginning indistinguishable from Medicine in itself. This first period, that of the myth of the founder, was followed, during the 19th century, by a positivist historiography, inspired by the myth of the precursor. Now, released from this double historiographical myth, present history of Medicine attempts to understand the past of Medicine, considering a set of factors that are together scientific, social and cultural.

"The paper proposes an evaluation of relative locations in Europe circa 1990, based on a new, probabilistic, formulation of the concept of population potential. The location of centres and peripheries, as highlighted by potential, varies according to the geographical importance of exchanges and the permeability of national boundaries. An extremely stable overall pattern emerges from two analyses, the one retrospective--using data for 1960--and the other prospective--based on the distribution of young people today--: regions with a high potential are located in concentric circles around the axis formed by the Rhine, not in the peripheral regions of Europe where population growth is higher." (SUMMARY IN ENG), (excerpt)

In order to realize the future Hermes and Columbus space-flights, European Space Agency decided to build up a european astronaut corps. Space-flights and training constraints require a strict initial selection among candidates. This paper describes space-flights psychological constraints, the aims of a psychiatric exam and its position in astronaut selection procedures as a whole. This paper also describes means and results of that selection among the candidates seen in Paris (France) in 1991.

Syst-Eur is a multicentre placebo-controlled outcome trial, designed by the European Working Party on High Blood Pressure in the Elderly (EWPHE), to investigate the effect of antihypertensive treatment on the incidence of stroke in elderly patients with isolated systolic hypertension (ISH). Eligible patients must be at least 60 years old and have a systolic blood pressure averaging 160-219 mmHg with a diastolic blood pressure less than 95 mmHg. The present paper in an interim report on the first 316 patients randomized into this trial. The placebo (N = 170) and active treatment (N = 146) groups were similar at randomization with respect to age (73 +/- 8 years; mean +/- standard deviation), sitting blood pressure (178 +/- 12/85 +/- 7 mmHg), percentage men (34%) and percentage of patients with cardiovascular complications (29%). After randomization blood pressure fell more (p < 0.001) on active treatment than in the placebo group (19 +/- 20/6 +/- 10 mmHg versus 7 +/- 19/1 +/- 10 mmHg for the sitting blood pressure). This first interim report on the Syst-Eur trial demonstrates that a multinational trial in elderly patients with ISH is feasible and that a significant blood pressure difference between the 2 treatment groups can be achieved and maintained. New centres are being recruited in order to randomize a total of 3,000 patients.

"The objective of this paper is to analyse the effects of recent immigration, from developing countries, to the Italian labour market. The presentation is divided into two parts. The first part deals with the phenomenon at the aggregate level. An interpretation of the effects of recent immigration into the labour market is presented, [including]...the expansion of the underground economy.... The second part is a closer analysis of the Italian case with special attention to the new laws and the migratory policy of the country." (SUMMARY IN ENG AND ITA), (excerpt)

This paper deals with the historical problem of "les Vapeurs". The word was largely used in ancient times, especially during the 18th century. The philosophical background goes back as far as Plato and Aristotle, but the turning point of the concept was given by a french scientist: B. Pomme. According his hypothesis "the nerves were shrinking because of drying" and the treatment had to be long, prolonged bathing. After being very fashionable, the treatment became obsolete and B. Pomme retired in his home city of Arles. This history of "les vapeurs" is of a great interest, because it shows how scientists are being easily abused by intellectual conceptions and words, only "words without meaning".

During the 18th, 19th, and at the beginning of the 20th century, various observations of inflammatory lesions of the colon and small intestine were published, which were different of tuberculosis to which was at that time attributed every chronical small intestinal inflammatory disease. It was only in 1932, that in a very important paper, Crohn, Ginsburg and Oppenheimer defined the terminal ileitis, afterwards called regional enteritis, and finally more simply Crohn's disease. Twenty years later, in 1952, Crohn's disease of the colon, confused until that date with colonic tuberculosis and with ulcerative colitis, was also identified as a separate entity. Since that time, the number of reported cases has tremendously increased through its is impossible to state whether the incidence of the disease has really increased or whether the diagnosis is done earlier and more precisely. Even today, the exacts limits of the disease are difficult to precise, since the causal agent of the disease is unknown, and that no biological test is completely secure. The present work reports 60 observations of chronic colitis, associated or not with small intestinal inflammation.

This paper is a study of the relationships between optics, right or left handedness and self-portrait, according to the concepts elaborated by Arthur Linksz. Four topics are studied: 1) Image reversal in the looking-glass: making his self-portrait, the painter looks at an self-image in a mirror, and so is copying an image of himself where right and left are, so to speak, inverted; eyes, ears, clothes, and above all, hands: the real right hand is the left hand in the picture, and the real left hand is the right hand in the picture. 2) Due to this reversal, the painter has two possibilities: either he can accept this apparent reversal, and represent himself as left-handed (painting using his left hand); or he can refuse this apparent reversal, and correct the reflected image in the picture. Both these options have in fact been used by painters, depending on whether they painted before or after the birth of photography: before photography, painters, generally, refused to seem left-handed; so, they used many tricks to correct the reflected image: suppression of the two hands in the self-portrait; suppression of the painted left hand (i.e. the real right hand); brushstroke in the painted right hand (i.e. the real left hand) and/or palette in the left painted hand (i.e.; the real right hand); only a few painters accepted to seem appearing left-handed in the self-portrait.(ABSTRACT TRUNCATED AT 250 WORDS)

"This paper examines two methods of indirectly estimating mortality: the Bourgeois-Pichat method (estimation of life expectancy at birth), and the Bourbeau and Legare method.... This last method consists of estimating various past mortality measures, for a given population, by examining these same measures as they were observed in certain other populations, during the period in question." These methods are applied to Norwegian data for 1826-1976. The results are then compared with data observed during the same period. The findings are used to evaluate the two methods and assess their advantages and disadvantages. However, the emphasis is on the Bourbeau and Legare method. (summary in ENG, SPA), (excerpt)

"Under some conditions, the comparison of life expectancies may lead to a much more accurate measure, in terms of dissimilarity between the empirical distributions of the number of years expected to live at each age. This paper analyses these conditions and applies the dissimilarity approach to the data of the Italian life tables of the 20th century." (SUMMARY IN ENG AND SPA), (excerpt)

This paper attempts to give an overview of current levels of child mortality prevailing in the world. It also examines trends and socioeconomic differentials in child mortality for selected countries and regions of the world. Lastly it reviews data on causes of child death and related environmental factors. The paper concludes that despite the fact that child deaths are frequently avoidable, mortality differentials between the developed and developing regions of the world are more pronounced in childhood (ages one to under five years) than at any other time of life. While some developing countries have substantially reduced the level of mortality in childhood, in others it remains very high. In contrast, in most developed countries child death rates are now so low, that they no longer serve as useful measures of public health.

Characteristics of family and household structure are examined in this paper to shed light on an important aspect of the life conditions of older persons in countries at different levels of development. Using various measures, both direct and indirect, the analysis showed the existence of a nuclear household as a predominant family form. Extended household families are more common in Asian countries, especially India, than in other regions for which data are available. While available cross-national data do not enable us to assess the extent to which older persons reside in households with their children, headship rates indicate that the majority of male older persons continue to maintain their position as heads of households in later life and that female headship increases with age. This is confirmed by analysis of data on marital status, which show higher proportions of males currently married than for females and sharply higher widowhood levels for females. Marriage at older ages seems to be relatively low. A general trend within most developed countries is toward increasing independent living, especially for females, and a sharp decline in both males and females living in a household with relatives.

The problem of selecting the monographs to be inserted in a pharmacopoeia does not actually exist on a national, but only on an international scale, as was realized during the compilation of the European Pharmacopoeia. The problems encountered at that time are discussed here. The first section of this paper describes the various principles, ideas and interpretations that are at the root of the divergent opinions expressed by the delegations at Strasbourg in facing this problem each time it comes up for discussion. These divergent opinions are centered mainly on the following: -developments and progress in the pharmaceutical profession; -differences existing among various national legislations; -basic concepts concerning pharmacopoeias; -more or less broad interpretations of the obligations set down in the Convention and in the General Rules of the European Pharmacopoeia; that is, in essence, the principle of the possibility of opposing the monographs and the application of this principle. On the basis of these considerations, the author advances, and tries to justify, the criteria that, according to him, should be adopted in order to arrive at common rules. The criteria are the following: -therapeutic interest, provided it is medically confirmed; -importance of usage, under the four specific aspects to be considered. On the subject of a new substance: -necessity that the product be produced by several manufacturers; there are three cases, where the rules to be observed have not been obeyed by all concerned. -obligation that the product be marketed in bulk, except in cases specifically established. While making this report, the author intends to emphasize the fact that a great effort is needed in order to narrow the gap separating certain points of view.

Geographic pathology has largely contributed to our knowledge of the epidemiology of digestive tract cancers. The characteristics of spatial and temporal distribution of oesophagus, stomach, colon and rectum cancers are described. The paper further discusses how more detailed breakdowns in geographic pathology might suggest new working hypotheses; this is illustrated by examples taken from recent literature.

"Who moves among the elderly? With whom do the elderly move? With whom will they stay once they have migrated? These are the main questions discussed in this paper. On the basis of a sample of individual data obtained from the censuses of Italy and the United States, data which were analysed by taking the household--and not, as is traditionally done, the individual--as the observation unit, the author concludes that there are some significant differences between the two countries as far as migration behavior of the elderly is concerned, even if there are also many similarities." (SUMMARY IN ENG AND SPA), (excerpt)

Anorexia nervosa is an adolescent pathology of the present. Its frequency is increasing in the western countries. New data concerning the criteria of diagnosis, the evolution, the prognosis, the psychopathology and the treatment have been drawn of numerous recent studies and are exposed in the paper.