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A sample of 199 elderly patients (over 75) admitted to emergency care sections of the Marne's (French department) public hospitals were monitored over six months. The purpose of this study was to assess the factors predicting death or institutionization of elderly patients, in order to improve patient care. Surveys were carried out to collect information on health, standards of living, family surrounding and background, social support and level of dependence. After 6 months, 63 (32%) have died and 19 (12.5%) have been directed to institutions. Risk of death factors are primarily connected with the environment. The risk was multiplied by three for patients placed in institutions and absence of children's visit increased the risk by seven. Dependence was also a risk factor. On the other hand, age and clinical diagnosis had little effect. Risk factors for institutionalization were: admission over the week end (OR = 29), non-accompanied (OR = 31), altered mental abilities (OR = 14), absence of children's visit (OR = 22). These predictors will render possible the rapid identification of high risk patients in every day practice. The improvement of gerontological competences in emergency care sections should enable quicker, more inclusive and adapted care. Measures to stimule or substitute for the failing natural relational network of elderly patients are also needed.

The effect of megavoltage irradiation with cobalt teletherapy or electron beam therapy has been evaluated in a series of 31 patients with extensive carcinoma of the maxillary antrum. Twelve of these patients were living, free of disease, at three years, and six out of 19 were alive at five years. From these results it seems that radical megavoltage radiation therapy can be relied upon to eradicate squamous carcinoma cells in bone in the management of advanced carcinoma of the maxillary antrum with its ethmoidal, orbital or pterygomaxillary extensions.

The local control and complications after radical irradiation were analyzed in 203 patients with supraglottic cancer, using time-dose scattergrams and nominal standard dose (NSD). A dose-response curve was obtained for early (T-1, T-2) tumors but was not demonstrated in advanced neoplasms (T-3, T-4). All nodes less than 2.5 cm in diameter were controlled with 7,000 rads. Of the early lesions 89% were controlled with 7,700 rads in six weeks. Over 85% of the involved nodes were controlled when the primary was cured. The incidence of major complications did not exceed 7%.