[Blood transfusion practices: about transfusions at night]. / Pratiques transfusionnelles à risque : à propos des transfusions de nuit.

Blood transfusion safety covers all stages from prescription of immuno-haematological examinations until the completion of the transfusion. According to the 05/11/2006 Afssaps' decision on good transfusion practices, transfusions should not be given at night unless the patient is actively bleeding or has some other urgent clinical need. A retrospective study was used to assess the proportion of transfusions at night. Through this professional practice evaluation, we analyze the reasons leading to perform transfusions at late hours, in order to reduce errors and improve safety for patients.

[Role of surgery in the management of pulmonary parasitosis]. / Place de la chirurgie dans les parasitoses pulmonaires.

Pulmonary parasitosis is scarcely encountered in France, and its diagnosis is quite difficult. If numerous parasites can be responsible for respiratory symptoms, only few of them can develop in the lung parenchyma and lead to complications necessitating a surgical treatment. The most common example is the hydatic disease of the lung. The authors review the biological cycles, clinical forms, diagnostic and treatment principles of those main lung parasites, which deserve surgical consideration.

[Evaluation of the Unicel DXC 600 (Beckman Coulter) and comparison with Integra 800 (Roche Diagnostics)]. / Evaluation des performances analytiques du système Unicel DXC 600 (Beckman Coulter) et étude de la transférabilité des résultats avec l'Integra 800 (Roche diagnostics).

The Unicel DXC 600 is an automated analytical system from Beckman Coulter for measuring usual biochemistry parameters (electrolytes, substrates and enzymatic activities), therapeutic drugs, drugs of abuse and specific proteins. According to the "Société française de biologie clinique (SFBC)" validation protocol, we tested the following parameters: electrolytes (sodium, potassium, chloride, total CO2), substrates (uric acid, calcium, phosphate, glucose, creatinine, urea, cholesterol, HDL cholesterol, bilirubin, iron, triglycerides), enzymes (ALAT, ASAT, amylase, CK, GGT, LDH, lipase, ALP), total proteins and specific proteins (albumin, CRP, haptoglobin). The results confirm the excellent analytical performances regarding imprecision. The comparison study shows differences between values obtained with Unicel DXC 600 and Integra 800 (Roche diagnostics), leading to the use of correcting factors for some parameters.

[Ethylene glycol intoxication: a case report]. / Intoxication par l'éthylène glycol : réflexion à propos d'un cas.

Ethylene glycol intoxication is one of the most serious acute poisonings due to the high toxicity that can result in death if not treated rapidly. We report the case of a patient who presented to the intensive care unit with a hypertensive crisis associated to a renal insufficiency. Laboratories investigations which revealed metabolic acidosis and elevated anion gap, highlighted an unexpected ethylene glycol intoxication. Clinical and psychiatric feature lead to suspect a chronic ingestion. Spontaneous recovery occured without specific treatment.

[Acute methanol poisoning: about one case]. / Intoxication aiguë au méthanol: réflexion à partir d'un cas.

In this article, we report a case of metabolic coma with acidosis and elevated anion gap. The etiological investigation requires laboratory findings because clinical features are not enough specific in the early stage of intoxication. Measurement of methanol and formic acid, its toxic metabolite, is useful in confirming the diagnosis. The major differential diagnosis to discuss is ethylene glycol poisoning. Methanol poisoning is rare but potentially fatal; the toxicity of methanol is clearly correlated to the degree of metabolic acidosis. Formic acid accumulation is also associated with an increased risk for ocular and neurologic dysfunction. For preventing permanent visual damage, the acidosis should be corrected by antidotal treatment or haemodialysis in severe poisoning.

[Amebic lung abscess: an unexpected diagnosis]. / Amibiase pleuropulmonaire: un diagnostic inattendu.

Pleuropulmonary amebiasis is a very rare complication of amebiasis infection and direct pulmonary involvement is exceptional. The clinical diagnosis is difficult without any intestinal or extraintestinal manifestations. A percutaneous drainage is necessary to aspirate pus. We report herein the case of a 56-year-old man presenting with an amebic lung abscess in his right lower lung and pleural effusion. The diagnosis was suspected by our laboratory from a serological assay (antiamebic antibodies reaching 320 by IHA) and established from a direct examination of the pus in which rare trophozoites of Entamoeba were detected. We pointed out the importance of the communication between the clinician and the biologist. Protozoan infection should be suspected in pleuropulmonary infection when antibiotics failed even in France. This patient left endemic area a long time ago and the way of his amebiasis contamination is unknown: recurrence of amebic infection is rare and prevalence in industrialized countries reaches only 1%. Several hypothesis are exposed.