[A comparative cost analysis of single-use versus reusable fiberoptic bronchoscopes: Is single-use fiberscope worth it?] / Analyse comparative de coût entre les fibroscopes bronchiques à usage unique et réutilisables : le fibroscope à usage unique, est-ce que ça vaut le coût ?

OBJECTIVE: To present a minimization-cost analysis to compare reusable and single-use fiberscopes in a French health institution. MATERIALS AND METHODS: The amortization cost assessment has been achieved over a period of five years, and took into account the acquisition and maintenance costs, as well as the costs related to disinfection of reusable fiberscopes. The cost of single-use fiberscopes was calculated according to its acquisition and elimination costs. Finally, we compared the costs of single-use vs. reusable use during nights, weekends and days off to estimate the additional cost of the referencing of single-use fiberscopes for theses specific periods. RESULTS: The total cost of reusable fiberscopes was 62,511 € including VAT over 5 years whereas the cost of single-use fiberscope was 79,200 € including VAT over 5 years. The total cost of single-use fiberscopes if utilized during nights, weekends and days off was estimated to 19,800 € including VAT over 5 years, with an estimated activity at 15 intubations per year. Conversely, the cost of the utilization of reusable fiberscopes during nights, weekends and days off was estimate to 13,075 € including VAT over 5 years. CONCLUSION: This study shows that the utilization costs of single use and reusable fiberscopes are very close. But because of the benefits of single-use fiberscopes and according to current recommendations, we consider to acquire single-use fiberscope especially for emergencies such as difficult tracheal intubation and for restrictive periods (nights, weekends and day off).

[Vascular factors in glaucoma]. / Facteurs vasculaires du glaucome.

The exact pathophysiology of glaucoma is not fully understood. Understanding of the vascular pathophysiology of glaucoma requires: knowing the techniques for measuring ocular blood flow and characterizing the topography of vascular disease and the mechanisms involved in this neuropathy. A decreased mean ocular perfusion pressure and a loss of vascular autoregulation are implicated in glaucomatous disease. Early decrease in ocular blood flow has been identified in primary open-angle glaucoma and normal pressure glaucoma, contributing to the progression of optic neuropathy. The vascular damage associated with glaucoma is present in various vascular territories within the eye (from the ophthalmic artery to the retina) and is characterized by a decrease in basal blood flow associated with a dysfunction of vasoregulation.