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Conducting an antidepressant treatment supposes the analysis of various parameters concerning patients, depressive illness and psychotropic drugs. The first determinant of prescription is the expected antidepressant effect. But regarding the role of compliance in the efficacy of treatment, probable tolerability also plays a role. It remains difficult to predict tolerability. A questionnaire was designed to assess the relevance of various predictive factors taken into account in the prognosis of tolerability: global tolerability, patient's psychopathological structure, clinical aspects of depression and characteristics of the particular antidepressant being used.

3H-imipramine shows specific, high-affinity binding to human platelet sites. The characteristics of these specific binding sites are very similar to those previously described in the rat brain. The inhibitory effects of 11 tricyclic antidepressants on 3H-imipramine binding to human platelets were investigated. There was a significant correlation between the inhibition observed and the average therapeutic doses of antidepressants, which suggests that the binding sites may be involved in the mode of action of these drugs. The number of binding sites (Bmax) for 3H-imipramine was compared in 39 controls and in 37 hospital patients with untreated severe depressive syndrome and was found to be significantly smaller in depressed patients, without any modification of the affinity constant Kd. The significance of these findings and their changes under treatment are discussed.

Since August 1977 total parenteral nutrition is part of post operative care for pull through operations for growth of floor of the mouth. The first 14 patients under total parenteral nutrition (from August 1977 until April 1980) are compared with the previous 14 patients. The length of the post operative period had slightly diminished but without statistical significance. On the other hand there is a significant difference for alimentary autonomy on discharge and number of complications (p less than 0.05). Our good handling of total parenteral nutrition has not replaced some complications by others.

Lesional pulmonary edema caused by substances which are directly caustic for the gastrointestinal pathways (strong acids and bases, inhaled vomit) are opposed by their immediate and long-term gravity with those due to cardiotropic medicamentatous toxins or volemic overloading which lead to curable pulmonary edema. Material and human factors, in favour of accidental intoxication are compensated for by the fact that many toxins produce vapours which are strongly irritant for the upper respiratory pathways: this prevents prolonged exposure and therefore wards off edema. Drug intoxication by ingestion can lead to pulmonary edema by relative or absolute volemic overload, by allergic accidents or by immaturity of the enzyme degradation systems. It seems to us that the notions of "neurological" and "metabolic" toxic edema should be abandoned. In lesional edema the treatment is that of the acute respiratory failure. The combination of pethidine, promethazine, and chlorpromazine gives good immediate results. Owing to careful follow-up, hemodynamic pulmonary edema should most frequently be avoided.

Cranial computerized tomography scan was used to study 16 cases of anorexia nervosa. The effect of treatment was explored by a second computerized tomography scan in 9 of the cases. Enlargement of cortical sulci and/or ventricular dilatation were demonstrated in 14 patients (87.5%). It was shown that the amelioration of body weight was related to the reversibility of computerized tomography scan abnormalities in 8 cases (89%). The authors discuss different aetiological hypotheses explaining these findings. They attempt to clear out the importance of the cranial computerized tomography in this disorder.