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Introduction: This paper examines whether the development of general medicine as a specialty in France since the mid-2000s has had an impact on medical theses. It analyses the changes resulting from the discipline's autonomatization process, involving an investment in some human and social science methods., Purpose of Research: In a diachronic approach, all dissertations defended in a general medicine department in 1999, 2007 and 2015 were analyzed (N = 291). We performed systematic coding of the types of methods used, the areas of research investigated, as well as the supervisors' areas of specialization. We used this coded data to develop a typology of research topics (using a hierarchic classification method based on the coordinates of a principal component analysis)., Results: Over the period under study, we observed a complexification of medical theses, which increasingly addressed multi-dimensional research topics. We also noted the emergence of new types of subjects, dealing with the exercise of the specialty and close to social science concerns (on the practices and dispositions of healthcare actors). Qualitative methods have been used more and more often, as a result of the increase in the number of theses supervised by GPs., Conclusions: The reform of general medicine has impacted the subjects treated and methods used in theses, and sheds light on the dynamics of the emergence of a new health research field.

Introduction: This paper examines whether the development of general medicine as a specialty in France since the mid-2000s has had an impact on medical theses. It analyses the changes resulting from the discipline's autonomatization process, involving an investment in some human and social science methods.Purpose of research: In a diachronic approach, all dissertations defended in a general medicine department in 1999, 2007 and 2015 were analyzed (N = 291). We performed systematic coding of the types of methods used, the areas of research investigated, as well as the supervisors' areas of specialization. We used this coded data to develop a typology of research topics (using a hierarchic classification method based on the coordinates of a principal component analysis)., Results: Over the period under study, we observed a complexification of medical theses, which increasingly addressed multi-dimensional research topics. We also noted the emergence of new types of subjects, dealing with the exercise of the specialty and close to social science concerns (on the practices and dispositions of healthcare actors). Qualitative methods have been used more and more often, as a result of the increase in the number of theses supervised by GPs., Conclusions: The reform of general medicine has impacted the subjects treated and methods used in theses, and sheds light on the dynamics of the emergence of a new health research field.

Our objective was to determine the maximum tolerated doses of tirapazamine and cyclophosphamide given i.v. in combination. Eligible patients had advanced solid tumors refractory to conventional treatment. Tirapazamine (escalated from 80 to 390 mg/m(2)) was given i.v. over 2 h and followed by cyclophosphamide over 1 h. The cyclophosphamide dose was fixed at 1000 mg/m(2) until the tirapazamine dose of 390 mg/m(2) was reached. Once that dose of tirapazamine was reached, the cyclophosphamide dose was escalated to 1250 and 1500 mg/m(2). Twenty-eight patients were enrolled. The dose-limiting toxicity was granulocytopenia. One patient had transient deafness for 2 days. Four other patients had grade 1 ototoxicity. Grade 1 and 2 muscle cramps were observed at all dose levels. Other toxic effects observed included fatigue, nausea, vomiting, headache, diarrhea, drug fever, elevated transaminases and elevated creatine phosphokinase. Three patients had stable disease and the longest time to progression was 5 months. The combination of tirapazamine and cyclophosphamide is feasible, and the dose-limiting toxicity is granulocytopenia. The use of growth factors could possibly allow escalation of tirapazamine doses in future phase II trials. Without growth factor support, the recommended doses of tirapazamine and cyclophosphamide when administered in this schedule are 260 and 1000 mg/m(2), respectively.

CK-isoenzymes were measured in 31 patients hospitalised for suspected myocardial infarctions who had an increase in serum creatine kinase (CK) above 50 U/l. Of 26 patients with definite evidence of myocardial infarction, MB-isoenzyme--specific for myocardial necrosis--was demonstrated in 24. MB-isoenzyme was no longer detectable in two patients hospitalised 48 hours after the onset of symptoms. In the remaining five patients only MM-isoenzyme was found, the elevated CK activity in three patients having been due to an intramuscular injection, and in two others due to pulmonary embolism. Measurement of CK isoenzymes proved of great diagnostic value in three patients with sudden circulatory arrest of, at first, unknown cause after successful resuscitation. Acute myocardial infarction was proven by the presence of MB-isoenzyme. In one of these patients an additional BB-isoenzyme was seen, possibly due to concomitant cerebral ischaemia. In all other patients (with angina, after cardioversion, or after major surgical operations) only MM-isoenzyme was detected. MB-CK-isoenzyme was found to be a highly specific, as well as sensitive, indicator of myocardial necrosis. This being a rather difficult method, its use is not justified in the routine diagnosis, but in doubtful instances its value can hardly be overestimated.