[Quality assurance program for blood products in an out-of-hospital medical care unit]. / Démarche d'assurance qualité pour l'hémovigilance en Smur.

INTRODUCTION: Transfusion of blood products is part of out-of-hospital medical activity. Despite rare use of transfusion and difficult environment, the rules of transfusion must be respected: follow up to detect blood products, security, and patient's information before and after transfusion, follow up of infectious and immunological consequences. However, the current law and usable documents were not conceived for out-of-hospital emergency care. OBJECTIVE: To improve follow-up of blood product transfusion in out-of-hospital medical care (Smur). STUDY DESIGN: Quality assurance programme. MATERIAL AND METHODS: a) Initial evaluation with a retrospective analysis based on the medical chart of patient for whom transfusion has been performed; b) corrective measures were proposed with creation of a specific document concerning transfusion and guidelines for blood product delivery in the out-of-hospital emergency care; c) evaluation of the impact of these correctives measures. RESULTS: Less than one per cent of patients treated by our Smur needed transfusion, mainly during interhospital transfer. Patients were in a life-threatening situation in 50% of cases. Follow-up improved after implementation of the programme from 25 to 83% of transfused patient (p < 0.001). Despite limitation due to the small number of patients, other parameters also improved. CONCLUSION: The use of specific guidelines and document improves the follow-up of transfusion in out-of-hospital medical care.

[Urinary infection in geriatric short stay: value of urinary strips]. / Infection urinaire en court séjour gériatrique: intérêt de la bandelette urinaire.

The blinded study of CBUE (cytobacteriological urine examination) test strips was carried out in 100 patients (65 women, 35 men), mean age 85.52 +/- 6.28 years, admitted for a short stay in a geriatrics department. Urinary infection was present in 19% of the cases. Typical clinical signs (pollakiuria, dysuria, hematuria, burning upon voiding) were rare, less than 10%. General signs, such as deterioration of general status (65% of the cases) and loss of autonomy (53% of the cases), on the other hand, were predominant and their relatively unspecific nature required a reliable screening test for urinary infection. Good results of sensitivity (89.5%), specificity (98.7%), and the leukocytes/nitrites values, confirmed the validity of the urine test strip in hospitalized elderly patients. In addition, the negative predictive value of the combination leukocytes and nitrites (90.8%) would have prevented 71 samples from being sent to the laboratory for CBUE, resulting in an obvious financial savings.

A new membrane electrode for the detection of antibody.

A new membrane electrode sensitive to specific antibody is described which incorporates dinitrophenyl antigen in polyvinyl chloride matrix membrane on to the surface of a solid-state graphite-loaded epoxy-resin electrode. The sensitivity of the electrode is based on the ionophoric property of the dinitrophenyl antigen. Response curves for the potassium ion and its specific antibody are reported.

[Diffuse hemangiomas of the skin and gastrointestinal tract. A case of blue rubber bleb naevus (author's transl)]. / Hémangiomatose disséminée de la peau et du tube digestif. Un cas de blue rubber bleb naevus.

The authors report the case of a 33-year-old patient with 109 skin hemangiomas of the blue rubber bleb naevus type, accompanied by angiomas of the mucosa of the gastrointestinal tract. Bleeding of the angiomas caused anemia. This case was apparently sporadic. The authors recall the clinical, histological and ultrastructural features of this rare disorder. Histology can help to differentiate BRBN from glomangioma.

[Thyroid nodules. A report on 320 cases (author's transl)]. / Les nodules thyroïdiens. Résultats de 320 observations.

An analytical study of 320 case reports of patients with one or more thyroid nodules, 246 of whom had been operated upon, revealed the presence of 32 cancers, 15 toxic nodules, and 195 inactive benign uni- or multilobular goitres. Complementary examinations (scintigraphy with technetium, thermography, ultrasonography) cannot definitely establish the benign nature of a nodule. As long as cytological examination after needle biopsy, which requires the services of a highly specialised cytologist, will not become a routine procedure, histological examination is essential for correct diagnosis. Any nodule should be excised, therefore, and the thyroid explored completely.