[Use and evaluation of the Belgian 3BT thesaurus adapted for Rwanda]. / Utilisation et evaluation du thésaurus belge 3BT adapté au Rwanda.

The Kigali university medical centre (CHUK) lacks visibility on its activities for many years. Institution management as well understanding the institution as the corner stone of the Rwandese health system and reinforcement of its visibility are all health policy major issues. Nevertheless, to this point no such tool has been developed nor implemented. The objective is to assess the feasibility of the use of the thesaurus 3BT as data collection tool in a Rwandese health institution. In august 2005, the thesaurus 3BT (Belgian, bilingual, biclassified ICD-10/ICPC-2) adapted to the CHUK has been implemented. Main issues: encoding quality and thesaurus operationality. Qualitative analysis has been performed on 899 coding of which 16 empty. Low occurrences (< or = 0.2%) of about 25% of codings of clinical diagnosis show the need for using a thesaurus but also to upgrade it. Near 45% of the empty codings could be fulfilled with a quick look to the original medical record. Some diagnoses are missing in the thesaurus 3BT. 66% of which have similar concepts in the thesaurus although not identifiable by a lay person. Finally, a clinical data blind coding test by a doctor used to classifications and by a lay person used to code clinical diagnosis from medical records of the hospitalised patients shows an exact similarity in 70% of the coding and a loss of coding precision in 20%. No coding error has been identified at this time. In conclusion, operationality of the thesaurus is quite acceptable in this study. The thesaurus makes easy the coding of clinical diagnosis even by lay people. Quality of data is enough to be able to interpret the quantitative results of the coding process. This study has to be repeated on a wider basis.

[Type B Haemophilus influenzae infections. Experience at the Pediatric Hospital of Luxembourg]. / Les infections à Haemophilus influenzae de type B. Expérience de la clinique pédiatrique de Luxembourg.

We have made a retrospective study of invasive Hib infections which have occurred in the Children's Hospital since 1980 to the end of July 1994; and we have been able to notice that since the introduction of vaccination against Hib, especially since it is free, the incidence of invasive Hib infections in the Grand Duchy of Luxembourg is in great decline.

[Joubert syndrome]. / Le syndrome de Joubert.

Joubert's syndrome is clinically characterized by attacks of tachypnea alternating with respiratory pauses, abnormal ocular movements, psychomotor retardation, and ataxia. Anatomic anomalies include cerebellar vermis agenesis with dilatation of the fourth ventricle. It is an autosomal recessive disorder; onset is in the neonatal period and prognosis is severe.

[A new case of hypersensitivity pneumopathy caused by salazopyrine?]. / Un nouveau cas de pneumopathie d'hypersensibilité à la Salazopyrine?

On the basis of a new case of Salazopyrine hypersensitivity pneumonitis, the authors describe the value of bronchoalveolar lavage and of the lymphoblast transformation test. They also describe the difficulties in making the diagnosis of such pathology and review the various possible differential diagnoses in their patient.

[Persistent left superior vena cava. Apropos of 2 cases]. / Veine cave supérieure gauche persistante. A propos de deux observations.

Double superior vena cava with persistence of a left superior vena cava is rarely encountered. The prevalence in the general population is 0.3% but may reach 3 to 10% in patients with inborn heart diseases. There are usually no clinical signs and the malformation is usually discovered fortuitiously. We describe the features of two cases observed in our institution and reviewed the literature on the subject.

Pulmonary mechanics in diffuse fibrosing alveolitis.

The mechanical and the diffusing lung properties have been measured in 19 cases of diffuse fibrosing alveolitis of unknown etiology (proved by histology in 17 cases). The characteristic findings are: a) a striking reduction of DLCO in all the cases; b) a marked reduction of the static and dynamic compliance, in correlation with the reduction of vital capacity; c) an increase in P1max in correlation with the decrease of FRC; d) an increase of the elastic recoil when it is considered at various percentages of the predicted lung volume, but in some cases a normal shape of the V-P curve if the measured lung volume is taken into account; e) a reduction of the maximum expiratory flows suggesting bronchiolar stenosis; f) alterations of DL more marked than those of CL suggesting that DL is a more sensitive test.