[Evaluation of midwives transfusion knowledge in Brittany public and private maternities, 2014]. / Évaluation des connaissances transfusionnelles des sages-femmes dans les maternités publiques et privées de la région Bretagne en 2014.

OBJECTIVES: This regional study aims to evaluate the transfusion knowledge of midwives in 22 Brittany maternity hospitals. MATERIALS AND METHODS: A multicentre, descriptive and comparative study used a questionnaire consisting in 16 theoretical questions about transfusion and questions being carried out. The analysis used the rate of correct answers and a pondered coefficient has been assigned to the different questions to evaluate the level of midwife knowledge. RESULTS: Twenty-two maternity hospitals participated in the study and 238 returned questionnaires could be analysed, a return rate of 36%. The rate of correct answers was between 5 and 98% depending on the questions; for example, the rate of correct answers of the ultimate control's reading varied between 64 and 98% and revealed that 5 to 7% of midwives would validate an incompatible transfusion. The average score was 31/50 with a minimum of 7/50 and a maximum of 44/50. Three statically significant links have been found according to the last year of training specific to blood transfusion, the graduation year and the level of maternity. CONCLUSION: This study revealed an insufficient knowledge of the transfusion among midwives and raised prospects, which could lead to an improvement of training courses offered to midwives.

What research agenda could be generated from the European General Practice Research Network concept of Multimorbidity in Family Practice?

BACKGROUND: Multimorbidity is an intuitively appealing, yet challenging, concept for Family Medicine (FM). An EGPRN working group has published a comprehensive definition of the concept based on a systematic review of the literature which is closely linked to patient complexity and to the biopsychosocial model. This concept was identified by European Family Physicians (FPs) throughout Europe using 13 qualitative surveys. To further our understanding of the issues around multimorbidity, we needed to do innovative research to clarify this concept. The research question for this survey was: what research agenda could be generated for Family Medicine from the EGPRN concept of Multimorbidity? METHODS: Nominal group design with a purposive panel of experts in the field of multimorbidity. The nominal group worked through four phases: ideas generation phase, ideas recording phase, evaluation and analysis phase and a prioritization phase. RESULTS: Fifteen international experts participated. A research agenda was established, featuring 6 topics and 11 themes with their corresponding study designs. The highest priorities were given to the following topics: measuring multimorbidity and the impact of multimorbidity. In addition the experts stressed that the concept should be simplified. This would be best achieved by working in reverse: starting with the outcomes and working back to find the useful variables within the concept. CONCLUSION: The highest priority for future research on multimorbidity should be given to measuring multimorbidity and to simplifying the EGPRN model, using a pragmatic approach to determine the useful variables within the concept from its outcomes.

[Transfusion-transmitted bacterial infection of a apheresis platelet concentrate with Streptococcus gallolyticus: Analysis of one case]. / Infection bactérienne à Streptococcus gallolyticus transmise par transfusion d'un concentré de plaquettes : à propos d'un cas.

Bacterial infections are uncommon complications of the blood products transfusion but they are potentially serious. Many advances have been done over the past few years to guarantee the microbiological security of blood products as the donors selection with a medical talk, the derivation of the first 30 millilitres blood during the donation, the deleucocytation of blood products… But in spite of these advances, cases of bacterial infection always remain. The purpose of this study was to point out the platelet concentrate's transfusion-transmitted bacterial infection with Streptococcus gallolyticus and the unusual consequence for the donor by uncovering an asymptomatic rectal neoplastic tumor. This study as raised as to whether the usefulness of systematic bacterial inactivation in the platelets concentrates.

[Results of a survey system for neurosurgical site infections, October 1998-January 2003]. / Résultats d'une surveillance des infections du site opératoire en neurochirurgie, octobre 1998-janvier 2003.

BACKGROUND AND PURPOSE: In the neurosurgery setting, incidence of surgical site infections (SSI) are considered as low to moderately low (1 to 10%). These infections are nevertheless a major problem because of the associated morbidity and mortality. A SSI survey system has been initiated in our neurosurgical unit. We report the incidence of SSI and identified SSI risk factors. METHODS: Data collected included demographic and medical information recorded with the operating room computer system. Any SSI occurring during the patient's postsurgical hospital stay or observed at postoperative visits was notified using a standardized questionnaire. SSIs were registered using Centers for Disease Control criteria. A multiple logistic regression model was used to determine SSI incidence and evaluate risk factors for SSI. Results were reported to the neurosurgical team every three months. RESULTS: From October 1998 to January 2003, 7399 operative procedures were collected. One hundred and twenty-two SSIs were notified with a mean incidence per patient of 1.65% (95% CI [1.37-1.95]). Among the SSIs 42% were superficial, 58% were deep or organ-space. Risk factors significantly associated with SSI were operation site (higher risk with CSF shunt), operation modality (higher risk with postponed operation) and operation duration greater than 75th percentile. CONCLUSION: SSI are an important problem in neurosurgery. This SSI survey gave us fundamental information about SSI and risk factors. Complementary studies are now necessary about postponed operative procedures. Propositions are made to improve the system.